Enter your Email address:
Wolters Kluwer Health may email you for journal alerts and information, but is committed
to maintaining your privacy and will not share your personal information without
You currently have no recent searches
Sarjeant, Jennifer M. MD; Callum, Jeannie L. MD, FRCPC
Department of Anesthesia, University of Toronto, Toronto, Canada
Director of Transfusion Medicine, Sunnybrook and Women’s College Health Science Centre, Toronto, Canada
To the Editor:
We were interested to read a case report of successful tourniquet use in a sickle cell patient (Hb SS) undergoing knee replacement (1). A case series of 12 Hb SS patients from the same institution in Saudi Arabia also demonstrated use of tourniquets without complication (2). In interpreting these results, it is important to note that Saudi Arabian patients have the Arab-Indian Hb SS haplotype, characterized by more benign disease, attributed to a higher percentage of fetal hemoglobin in their circulation (an average of 25% versus 5–10% in African haplotypes) (3). A case series from Africa, in contrast to the Saudi Arabian experience, reported that 3 of 14 Hb SS patients developed sickle cell related complications after surgery with tourniquet use (4). Given that 83–100% of Hb SS patients in the United States are African haplotypes (6), tourniquet use may not be appropriate for most sickle cell patients in North America.
Also in this report (1), the patient underwent preoperative exchange transfusion reducing Hb S from 82.6% to 47%. However, a RCT demonstrated that simple preoperative transfusion (total Hb to 10 g/dL) was as effective as exchange transfusion (Hb S <30% of total) in preventing perioperative complications in Hb SS patients, and was also associated with a 50% reduction in transfusion-related complications (5). Thus, preoperative exchange transfusion is rarely indicated.
Jennifer M. Sarjeant, MD
Jeannie L. Callum, MD, FRCPC
© 2004 International Anesthesia Research Society
Colleague's E-mail is Invalid
Your Name: (optional)
Separate multiple e-mails with a (;).
Thought you might appreciate this item(s) I saw at Anesthesia & Analgesia.
Send a copy to your email
Your message has been successfully sent to your colleague.
Some error has occurred while processing your request. Please try after some time.
An Existing Folder
A New Folder
The item(s) has been successfully added to "".
Login with your LWW Journals username and password.
Username or Email:
Need to Activate a New Subscription?Recently purchased a subscription? Login or Register a new account
and enter your subscription ID, or Subscribe Now!
Become a Society Member
Enter and submit the email address you registered with. An email with instructions to reset your password will be sent to that address.
Link to reset your password has been sent to specified email address.
What does "Remember me" mean?
By checking this box, you'll stay logged in until you logout. You'll get easier access to your articles, collections,
media, and all your other content, even if you close your browser or shut down your
To protect your most sensitive data and activities (like changing your password),
we'll ask you to re-enter your password when you access these services.
What if I'm on a computer that I share with others?
If you're using a public computer or you share this computer with others, we recommend
that you uncheck the "Remember me" box.
Save my selection
Article Level Metrics