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Comparison of Cardiopulmonary Complication Rates in Patients Undergoing Total Knee Arthroplasty and Reinfusion of Shed Blood

Hanlon, Laura; Punzo, Amalia; Jones, Ruth Ann; Speroni, Karen Gabel

doi: 10.1097/NOR.0b013e31822c5a92

BACKGROUND, SIGNIFICANCE, AND PURPOSE: Nurses noted a trend in increasing cardiopulmonary complications postoperatively in patients undergoing total knee arthroplasty (TKA) who had received reinfused shed blood. The purpose of this retrospective study was to compare cardiopulmonary complications in TKA patients admitted to the Joint Replacement Center in a rural community hospital.

DESIGN AND METHODS: Retrospective research was conducted to compare outcomes in 242 patients (Group 1 = patients reinfused with shed blood [n = 78]; Group 2 = patients not reinfused [n = 164]). Data were analyzed using Premier's Quality Advisor.

RESULTS: Results showed a statistically significant difference in cardiopulmonary complication rates between the two groups. Group 1 had a greater rate than Group 2 for cardiac complications (Group 1 = 6.4%; Group 2 = 1.8%), pulmonary embolisms (Group 1 = 5.1%; Group 2 = 1.2%), and other pulmonary complications (Group 1 = 3.8%; Group 2 = 1.2%). Transfusions were administered to more Group 1 patients (52%) than Group 2 (27%).

CONCLUSIONS: Cardiopulmonary complication rates were significantly higher in patients using the reinfusion device. As a result of this study, the standard of practice for the care of postoperative TKA patients has changed and the reinfusion device is no longer utilized.

Laura Hanlon, BSN, RN, Coordinator Joint Replacement Center, Easton, MD.

Amalia Punzo, MD, Medical Director, Quality Improvement and Patient Safety, Easton, MD.

Ruth Ann Jones, EdD, MSN, RN, NEA-BC, Director, Acute Care, Easton, MD.

Karen Gabel Speroni, PhD, RN, Chair, Nursing Research Council, Easton, MD.

© 2011 National Association of Orthopaedic Nurses