<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-0390</journal-id>
<journal-title><![CDATA[Revista Médica del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Méd. Urug.]]></abbrev-journal-title>
<issn>1688-0390</issn>
<publisher>
<publisher-name><![CDATA[Sindicato Médico del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-03902017000400043</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Estrategia restrictiva transfusional en cirugía ortopédica]]></article-title>
<article-title xml:lang="en"><![CDATA[Restrictive transfusion strategy in orthopedics surgery]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pintos]]></surname>
<given-names><![CDATA[Marcos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ventura]]></surname>
<given-names><![CDATA[Verónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tarallo]]></surname>
<given-names><![CDATA[Maximiliano]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rienzi]]></surname>
<given-names><![CDATA[Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Decaro]]></surname>
<given-names><![CDATA[Jorge]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cancela]]></surname>
<given-names><![CDATA[Mario]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Pasteur Clínica Médica 2 ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Pasteur Clínica Médica 2 ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,Asociación Española  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af4">
<institution><![CDATA[,Asociación Española  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af5">
<institution><![CDATA[,Asociación Española  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af6">
<institution><![CDATA[,Hospital de Clínicas  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<volume>33</volume>
<numero>4</numero>
<fpage>43</fpage>
<lpage>52</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-03902017000400043&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-03902017000400043&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-03902017000400043&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: Para pacientes que sufren artrosis avanzada o en algunos casos de fractura de cadera, la solución quirúrgica que se propone es la cirugía ortopédica mayor. Alguno de estos pacientes requerirá transfusión de sangre o hemocomponentes, o ambos, antes o después de la intervención El abordaje de la anemia en el paciente quirúrgico puede hacerse de manera liberal, sujeto a la indicación de cada cirujano, o en el contexto de un protocolo restrictivo de reposición. Con este último el beneficio en el ahorro de recursos se acompaña además de un menor número de complicaciones relacionadas con la administración de sangre alogénica El objetivo específico de nuestro trabajo fue comparar la estrategia liberal con la terapia restrictiva transfusional. Ingresaron en el estudio 498 pacientes; de estos, 261 (52,4%) en el año 2014 sometidos a terapia liberal y 237 (47,6%) en el año 2015 a quienes se aplicó el protocolo de terapia restrictiva transfusional. Se transfundieron menos individuos y se indicaron 55% menos volúmenes de sangre con la estrategia restrictiva. Se presentaron diez casos de reacción transfusional, todas de tipo febril, ocho en 2014 y dos en 2015. Con respecto a la evolución funcional no se comprobó diferencia entre ambos grupos. En nuestra experiencia y de acuerdo a la literatura consultada, la terapia restrictiva permite alcanzar iguales resultados funcionales, con menor riesgo para el paciente y ahorraría recursos al sistema]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Major orthopedic surgery is the surgical solution proposed for patients who suffer from advanced arthrosis or for some cases of hip fracture. Some of these patients will require blood and/or blood components transfusion before or after surgery. The approach to anemia in surgical patients may involve a liberal or a restrictive transfusion strategy, according to what each surgeon indicates, or observing the context of a restrictive protocol for blood replacement. The latter results in resource savings and in a reduction in the number of complications due to the administration of allogenic blood. The study aims to compare the liberal transfusion strategy to the restrictive strategy. 498 patients were included in the study, 261 of which (52.4%) were treated within the liberal strategy in 2014, and 237 (47.6%) were treated according to a restrictive transfusion protocol in 2015. A smaller number of individuals received blood transfusions and 55% less blood volumes were needed when the restrictive strategy was applied. Ten cases of transfusion reaction arose, all of them involving fever, 8 in 2014 and 2 in 2015. As to the functional evolution, no differences were found between the two groups. According to our study, and according to the global literature consulted, the restrictive therapy strategy enables the same functional results with a lower risk for patients, and it saves resources for the system]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: Para pacientes com artrose avançada ou em alguns casos de fratura de quadril, a solução cirúrgica que se propõe é a cirurgia ortopédica maior. Algum destes pacientes necessitará transfusão de sangue e/ou hemocomponentes antes ou depois da intervenção. A abordagem da anemia no paciente cirúrgico pode ser feita de maneira liberal, sujeito à indicação de cada cirurgião, ou seguindo um protocolo restritivo de reposição. Utilizando este último se observa um beneficio não só na economia de recursos como também por um menor número de complicações relacionadas com a administração de sangue alogênica. O objetivo específico deste trabalho foi comparar a estratégia liberal com a terapia restritiva transfusional. Foram incluídos no estudo 498 pacientes, sendo 261 (52,4%) em 2014 submetidos à terapia liberal, e 237 (47,6%) em 2015 quando se utilizou o protocolo de terapia restritiva transfusional. Um número menor de pacientes necessitou transfusão sanguínea e foram indicados 55% menos volumes de sangre com a estratégia restritiva. Foram registrados 10 casos de reação transfusional, todas do tipo febril, oito em 2014 e 2 em 2015. Com respeito à evolução funcional, não foram observadas diferenças entre ambos os grupos. Na nossa experiência e de acordo com a literatura consultada, a terapia restritiva permite alcançar resultados funcionais iguais com menos riscos para o paciente e pouparia recursos ao sistema]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Transfusión sanguínea]]></kwd>
<kwd lng="es"><![CDATA[Cirugía ortopédica mayor]]></kwd>
<kwd lng="es"><![CDATA[Anemia]]></kwd>
<kwd lng="en"><![CDATA[Blood transfusión]]></kwd>
<kwd lng="en"><![CDATA[Majororthopedicsurgery]]></kwd>
<kwd lng="en"><![CDATA[Anemia.]]></kwd>
<kwd lng="pt"><![CDATA[de sangue]]></kwd>
<kwd lng="pt"><![CDATA[Cirugía ortopédica maior]]></kwd>
<kwd lng="pt"><![CDATA[Anemia]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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