Abstract:
BACKGROUND:Patient blood management (PBM) can prevent preoperative anaemia, but little is known about practice in Europe. OBJECTIVE:To assess the pre and postoperative prevalence and perioperative management of anaemia in patients undergoing elective orthopaedic surgery in Europe. DESIGN:An observational study; data were collected from patient records via electronic case report forms. SETTING:Seventeen centres in six European countries. Centres were stratified according to whether they had a PBM programme or not. PATIENTS:One thousand five hundred and thirty-four patients undergoing major elective hip, knee or spine surgery [49.9% hip, 37.2% knee, 13.0% spine; age 64.0 years (range 18 to 80), 61.3% female]. MAIN OUTCOME MEASURES:Prevalence of preoperative (primary endpoint) and postoperative anaemia [haemoglobin (Hb) <13 g dl (male), Hb <12 g dl (female)], perioperative anaemia management, time to first blood transfusion and number of transfused units. Data are shown as mean (SD) or median (interquartile range). RESULTS:Anaemia prevalence increased from 14.1% preoperatively to 85.8% postoperatively. Mean Hb decrease was 1.9 (1.5) and 3.0 (1.3) g dl in preoperatively anaemic and nonanaemic patients, respectively (P < 0.001). In PBM (n = 7) vs. non-PBM centres, preoperative anaemia was less frequent (8.0 vs. 18.5%; P < 0.001) and iron status was assessed more frequently (ferritin 11.0 vs. 2.6%, transferrin saturation 11.0 vs. 0.1%; P < 0.001). Perioperative anaemia correction (mainly transfusion) was given to 34.3%. Intraoperatively, 14.8% of preoperatively anaemic and 2.8% of nonanaemic patients received transfusions [units per patient: 2.4 (1.5) and 2.2 (1.4), median time to first intraoperative transfusion: 130 (88, 158) vs. 179 (135, 256) min; P < 0.001]. Postoperative complications were more frequent in preoperatively anaemic vs. nonanaemic patients (36.9 vs. 22.2%; P = 0.009). CONCLUSION:Most patients who underwent elective orthopaedic surgery had normal preoperative Hb levels but became anaemic after the procedure. Those who were anaemic prior to surgery had an increased intraoperative transfusion risk and postoperative complication rate. PBM measures such as iron status assessment and strategies to avoid transfusion are still underused in Europe.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Lasocki S,Krauspe R,von Heymann C,Mezzacasa A,Chainey S,Spahn DRdoi
10.1097/EJA.0000000000000202subject
Has Abstractpub_date
2015-03-01 00:00:00pages
160-7issue
3eissn
0265-0215issn
1365-2346journal_volume
32pub_type
杂志文章,多中心研究abstract:BACKGROUND AND OBJECTIVE:Administration of calcium safely and effectively reverses many of the electrophysiological actions of hyperkalaemia, but it has not been studied for pretreatment. Based on cellular studies, magnesium also has been suggested to prevent the effects of potassium on the heart. As their mechanisms o...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021503000978
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Little has been documented about the development of pain after ophthalmic surgery. This study was designed to assess the incidence and severity of postoperative pain following ophthalmic surgery, and to identify key factors independently associated with development of such pain. METHODS:In a p...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021504002042
更新日期:2004-02-01 00:00:00
abstract::The suitability of tramadol suppositories for inclusion in our hospital formulary for the treatment of mild to moderate post-operative pain was evaluated. In an open randomized trial, rectal tramadol was compared with our standard treatment acetaminophen/codeine suppositories. We expected tramadol to be equally effect...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2346.1999.00520.x
更新日期:1999-07-01 00:00:00
abstract:CONTEXT:Unexpected difficulty in tracheal intubation is an intermittent and often terrifying problem for all practising anaesthetists. There are many preoperative assessment tests to predict a difficult laryngeal view or a difficult intubation, but we found no published evidence of how frequently these predictive tests...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e32835103e6
更新日期:2012-05-01 00:00:00
abstract::Intrathecal midazolam for use as a post-operative analgesic when given alone and in conjunction with intrathecal diamorphine was assessed. Fifty-two patients scheduled for elective Caesarean section under spinal anaesthesia were randomly allocated to receive either bupivacaine (B), bupivacaine with diamorphine (BD), b...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2346.1996.00044.x
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The effects of sevoflurane on bupivacaine cardiotoxicity are mainly attributed to systemic effects. The purpose of this study was to investigate the direct myocardial effects of sevoflurane on bupivacaine toxicity. METHODS:Hearts of 30 Wistar albino rats were isolated and mounted on a Langendo...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021503000346
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Pressure-based dynamic variables are poor predictors of fluid responsiveness in children, and their predictability is expected to reduce further during lung-protective ventilation with a low tidal volume. OBJECTIVE:We hypothesised that lung recruitment manoeuvre (LRM)-induced changes in dynamic variables im...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001387
更新日期:2020-11-11 00:00:00
abstract:BACKGROUND:Septic encephalopathy is believed to be a result of neuro-inflammation possibly triggered by endotoxins, such as lipopolysaccharides (LPS). Modulation of the immune system is a property of volatile anaesthetics. OBJECTIVE:We aimed to investigate the systemic and cerebral inflammatory response in a LPS-induc...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000668
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Better understanding of risk factors for adverse events during monitored anaesthesia care (MAC) for paediatric gastrointestinal endoscopy may improve outcome in children. OBJECTIVES:To identify the prevalence and predictors of adverse events during MAC for paediatric endoscopy. DESIGN:An observational stud...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000995
更新日期:2019-06-01 00:00:00
abstract::A hemiarthroplasty for femoral neck fracture was successfully performed under combined epidural anaesthesia and light general anaesthesia before phaeochromocytoma removal. Pre-operative therapy was managed with doxazosin, enalapril and diltiazem. Peri-operative management facilitated maintenance of stable haemodynamic...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To evaluate the current clinical attitude in enteral nutrition support and motility disorders in adult critically ill patients on German intensive care units. METHODS:A total of 1493 questionnaires, including 25 items on the medical environment, treatment of motility disorders and enteral nutr...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021507002657
更新日期:2008-01-01 00:00:00
abstract::Perioperative myocardial infarction or ischaemia is a potential consequence of cardiac surgery and elevated free fatty acids can increase the severity of myocardial ischaemic damage. We investigated perioperative changes in serum free fatty acids, and other serum lipids, as a consequence of using propofol infusions fo...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.0265-0215.2000.00789.x
更新日期:2001-02-01 00:00:00
abstract:CONTEXT:Previous research has shown that most patients are satisfied with their anaesthetic care. For those who are not the causes may be multifactorial including dissatisfaction with surgical outcomes. OBJECTIVES:We aimed to identify whether quality of recovery after anaesthesia and surgery measured in multiple domai...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/EJA.0b013e328357e584
更新日期:2013-03-01 00:00:00
abstract::A variety of laboratory and clinical studies clearly indicate that exposure to anaesthetic agents can lead to a pronounced protection of the myocardium against ischaemia-reperfusion injury. Several changes in the protein structure of the myocardium that may mediate this cardioprotection have been identified. Ischaemia...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1017/s0265021505001080
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Previous data show that lidocaine or magnesium has unique characteristics of stress inhibition and antiinflammation. OBJECTIVE:We aimed to observe the effects of lidocaine or magnesium on the quality of recovery (QoR) after laparoscopic cholecystectomy. DESIGN:Single-centre, prospective, randomised, double...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001348
更新日期:2021-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:It is known that esmolol, a short-acting beta1-blocker, reduces anaesthetic requirement. In this study, we evaluated whether a low dose of landiolol, a new ultra-short-acting beta1-blocker, can reduce the sevoflurane requirement. METHODS:Twenty-five patients undergoing hip surgery were randoml...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e328318c6a9
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:the objective of this study was to assess whether antiemetic drugs metoclopramide and diphenhydramine, administered together as opposed to alone, can have better efficacy in preventing postoperative nausea and vomiting when added to patient-controlled morphine analgesia. PATIENTS AND METHODS:d...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32833f53b8
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Volatile anaesthetics are a potential hazard during occupational exposure, pregnancy or in individuals with existing disposition to malignant hyperthermia. Anaesthetic waste gas concentration in postanaesthesia care units (PACU) has rarely been investigated. OBJECTIVE(S):The current study aims to assess con...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000785
更新日期:2018-07-01 00:00:00
abstract::Stellate ganglion block is a selective sympathetic block that affects the ipsilateral head, neck, upper extremity and upper part of the thorax. Convulsions are a recognized complication of intra-arterial injection during stellate ganglion block. As central nervous system toxicity depends ultimately on the concentratio...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
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更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:The use of noradrenaline to enable a restrictive approach to intra-operative fluid therapy to avoid salt and water overload has gained increasing acceptance. However, concerns have been raised about the impact of this approach on renal function. OBJECTIVES:To identify risk factors for acute kidney injury (A...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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更新日期:2018-09-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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更新日期:2011-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:In the perivascular sheath of the brachial plexus, the volume of anaesthetic solution determines the quality of anaesthetic cover. Fibrous septa may divide the perivascular space into compartments, leading to inadequate diffusion of the anaesthetic solution. The aim of our study was to obtain g...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021506001074
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To examine whether prophylactic use of haloperidol in addition to dexamethasone decreased the incidence of postoperative nausea and vomiting in high-risk patients undergoing ambulatory surgery. METHODS:One hundred and sixty nonsmoking women aged between 18 and 50 years receiving a standardized...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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更新日期:2010-02-01 00:00:00
abstract::The post-operative period is particularly dangerous for obese patients. The aim of this study was to compare the immediate post-operative course after either laparoscopic or open gastroplasty. We studied retrospectively 20 and 14 consecutive patients who underwent laparoscopic or open adjustable silicone gastric bandi...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1999.00510.x
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:We have evaluated the effects of propofol and its relationship with K+ channels on human isolated umbilical vessels. METHODS:Umbilical vessel rings were suspended in isolated organ baths containing Krebs-Ringer solution. In the first series of experiments the effect of propofol (10(-9)-10(-4) ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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更新日期:2006-05-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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更新日期:2019-03-01 00:00:00
abstract::A 25-year-old primigravida with bilateral phaeochromocytomas was managed from 6 weeks' gestation until 2.5 years following combined Caesarean section and removal of adrenal tumours. Pre-operative alpha-blockade was achieved by oral prazosin without deleterious effects. Intra-operative management comprised neuroleptana...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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更新日期:1985-12-01 00:00:00
abstract:BACKGROUND:Post-anaesthetic shivering is one of the most common complications, occurring in 5-65% of patients recovering from general anaesthesia and 33% of patients receiving epidural anaesthesia. Our objective was to investigate the efficacy of intraoperative dexmedetomidine infusion on postoperative shivering. METH...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021507003110
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Pre-operative anaemia is associated with adverse outcomes of noncardiac surgery, but its association with myocardial injury after noncardiac surgery (MINS) has not been fully investigated. OBJECTIVE:The association between pre-operative anaemia and MINS. DESIGN:A single-centre retrospective cohort study. ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001421
更新日期:2021-01-04 00:00:00
abstract:BACKGROUND:The impact of anaesthetic techniques on recurrence of cancers is controversial. Elevated plasma catecholamine levels have been implicated in angiogenesis and metastasis in various cancers. OBJECTIVES:To assess the potential association between continuous intra-operative norepinephrine administration and tum...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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更新日期:2020-05-01 00:00:00