Is cell salvage cost-effective in posterior arthrodesis for adolescent idiopathic scoliosis in the public health system?

Oliveira, José Alberto Alves; Filho, Fernando Antônio Mendes Façanha; Fernandes, Francisco Valmir; Almeida, Paulo César de; Oliveira, Vládia F de; Verde, Saulo Rabelo Lima

doi:10.21037/jss.2017.02.01

Cited by 12 publications

(28 citation statements)

References 9 publications

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“…5 PABD and intraoperative CS with Cell-saver systems are widely utilized for blood conservation in PIF for AIS in recent years. 3,9,10,12 However, much controversy exists in current literature about these methods' safety and effi cacy, in terms of decreasing ABT potentiality.…”

Section: Discussionmentioning

confidence: 99%

“…7 The overwhelming majority of literature reports advocate that Cell-saver intraoperative recruitment is associated with a remarkable decrement in intraoperative blood transfusion potentiality (Table 3). 2,3,11,[16][17][18][19] Postoperative clinical outcomes are not unfavorably affected with Cell-saver utilization. 17 Oliveira et al argued that CS utilization was Table 3.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Effectiveness of these techniques in ABT potentiality decrement has been extensively studied in current literature. 2,3,[8][9][10][11] However, none of these studies reported any particular results about utilization of these techniques in conjunction, in terms of altering ABT rates.…”

Section: Reviewmentioning

confidence: 99%

“…Posterior instrumented fusion (PIF) surgery for adolescent idiopathic scoliosis (AIS) is unfavorably associated with substantial blood loss. [1][2][3] Allogeneic blood transfusion (ABT) emerges as a fundamental necessity in this situation. Nevertheless, ABTs are associated with signifi cant increase of perioperative morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…4 Transmission of viral diseases (HBV, HCV and HIV), as well as effects on the immunological function are considered responsible for transfusion-related acute lung injury (TRALI), postoperative bacterial infections and hemolytic transfusion reactions. 3,4 The above are the major adverse effects of ABT, which is also considered to have a remarkable impact on socioeconomics being related to signifi cant costs. 5 ABT avoidance represents thus a veritable requisiteness.…”

Section: Introductionmentioning

confidence: 99%

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Perioperative Blood Management in Posterior Instrumented Fusion for Adolescent Idiopathic Scoliosis: Original Study and Short Review of the Literature

et al. 2018

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Background: The potential hazards of allogeneic blood transfusion are well established in literature. Few things are known, however, about the results of combining different blood saving techniques and their results in avoiding allogeneic blood transfusion (ABT) in scoliosis surgery. Aim: To report specific results about utilization of preoperative autologous blood donation (PABD) and intraoperative blood-saver (BLDS) in conjunction, aiming to minimize the need for ABT. Materials and methods: Between 1989 and 2012, 107 patients underwent posterior instrumented fusion (PIF) for adolescent idiopathic scoliosis (AIS) correction. Retrospective evaluation was conducted. Patients were classified into two groups, according to the method utilized: group A with only allogeneic blood transfusion (ABT) and group B where PABD with BLDS intraoperatively was applied. Hematocrit and hemoglobin values were evaluated preoperatively, postoperatively, and at discharge. The variables we examined included also gender, age, levels fused and number of predeposited blood units, required transfused blood units (TBU), as well as ABT rates between the two groups. Results: More than 70% of the transfusions in both groups were needed intraoperatively. In group A, an average of 2.4 units per patient was transfused and ABT reached 76%. In contrast, in group B an average of 4.5 units per patient was transfused but ABT rate was only 7.3%, while the rest 92.7% was autologous blood. However, the wasted autologous blood reached 24.9%. Conclusions: Our results demonstrated that PABD with intraoperative cell salvage (CS) is associated with statistically significant ABT rates decrement but the combination of these methods cannot assure ABT avoidance.

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