Randomized clinical trial of intraoperative autotransfusion in surgery for abdominal aortic aneurysm

Mercer, K. G.; Spark, J.I.; Berridge, David; Kent, P.; Scott, D. J. A.

doi:10.1002/bjs.4793

Cited by 43 publications

(32 citation statements)

References 21 publications

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“…21 This study concluded that a significantly smaller number of patients required homologous transfusion in the ICS group; the ratio between the mean numbers of transfused allogeneic units per patient was determined to be 1:3 (ICS vs no ICS group). Furthermore, more patients in the group without ICS use developed systemic inflammatory response syndrome following surgery (Table 8).…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Cell Salvage versus Allogeneic Transfusion during Abdominal Aortic Surgery: Clinical and Financial Outcomes

et al. 2009

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The objective of this study was to assess the clinical and financial outcomes of intraoperative cell salvage (ICS) during abdominal aortic surgery. In this study, 90 patients were operated on with the use of ICS (group 1, prospective) and 90 patients without ICS (group 2, historical control). According to the type of operation, the patients were subdivided into three consecutive 30-patient subgroups (1, aortoiliac occlusive disease [AOD]; 2, elective abdominal aortic aneurysm [AAA]; or 3, ruptured abdominal aortic aneurysm [RAAA]). Transfusion requirements and postoperative complications were recorded. The total amounts of perioperatively transfused allogeneic blood were higher in all patient subgroups that underwent surgery without ICS (p = .0032). In the ICS group, 50% of AOD patients and 60% of elective AAA patients received no allogeneic transfusions. There were no significant differences in the incidence of postoperative complications in any group examined. ICS significantly reduced the necessity for allogeneic transfusions during abdominal aortic surgery. ICS use was most valuable in urgent situations with high blood losses, such as RAAA, for which only small amounts of allogeneic blood were initially available. In patients with more than 3 units of autologous blood reinfused, this method was cost effective.

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Section: Discussionmentioning

confidence: 99%

Intraoperative Cell Salvage versus Allogeneic Transfusion during Abdominal Aortic Surgery: Clinical and Financial Outcomes

et al. 2009

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“…Autologous blood reinfusion has been increasingly used in clinics. There have been studies[121314] demonstrated that autologous blood reinfusion not only raised post-operative hemoglobin level, reduces the occurrence of systemic inflammatory response syndrome and infection, but also increases serum creatine kinase-MB level, playing a certain role in myocardial cell repairing. As regards the cost of blood transfusion, transfusion in the control group cost averagely 3450 Chinese Yuan, while the transfusion cost in the experimental group averaged at 2250 Chinese Yuan which included the pre-operative autologous blood deposit cost 160 Chinese Yuan, the intra-operative blood salvage cost 1000 Chinese Yuan and the allogeneic blood transfusion cost (if any).…”

Section: Discussionmentioning

confidence: 99%

Application of controlled hypotension combined with autotransfusion in spinal orthomorphia

Zhou

Xuesong

et al. 2014

Anesth Essays Res

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Background:Idiopathic scoliosis is a common spinal deformity in teenagers, which is managed mainly by orthomorphia. However, due to great trauma, long operative duration and large blood loss, a great amount of blood transfusion is needed during the surgery. Allogeneic blood transfusion should be reduced in order to release blood insufficient, decline blood transfusion expense, as well as avoid transfusion diseases.Objective:The objective of the following study is to investigate the value of controlled hypotension combined with autotransfusion in idiopathic scoliosis orthomorphia and in order to reduce surgical bleeding and reduction in blood transfusion.Subjects and Methods:Intra-operative controlled hypotension was performed during posterior orthomorphia surgery on all the 46 cases of idiopathic scoliosis, 17 cases in which were served as the control group, who underwent allogeneic blood transfusion without autotransfusion, whereas the other 29 cases were served as the experimental group, who underwent autotransfusion that including reinfusion of pre-operative deposited autologous blood and intra-operative salvaged autologous blood. The blood loss volume and transfusion status in two groups were observed.Results and Conclusion:Blood loss volume in the control group was 400-1000 (835.3 ± 167.5) mL and that in the experimental group was 350-1400 (812.1 ± 152.7) mL, there was no marked difference between the two groups (P > 0.05). The volume of allogeneic blood transfusion in the control group was 500-1800 (855.9 ± 321.1) mL, which was greater than that in the experimental group ((0-1300 (337.9 ± 258.3) mL) (P < 0.01). The results suggested that controlled hypotension reduces intraoperative bleeding and post-operative autotransfusion minimizes the need of allogeneic blood transfusion.

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“…Zusätzlich werden dabei proinflammatorische Zytokine und Komplementfaktoren deutlich gesenkt. Auch in der Gefäßchirurgie, etwa bei abdominalem Aortenaneurysma, kann es zu einem erheblichen Blutverlust kommen, bei dem MAT nicht nur den Transfusionsbedarf, sondern auch die postoperative Entwicklung von Infektionen und "systemic inflammatory response syndrome" reduziert (SIRS; [19]). Die Anwendung der MAT in der Geburtshilfe ist bei der geringen Transfusionsrate und der bisher begrenzten Zahl klinischer Studien umstritten und sollte auf lebensbedrohliche Blutungen sowie spezielle Situationen begrenzt bleiben [17].…”

Section: Massivtransfusionunclassified

Maschinelle Autotransfusion

Hansen

Seyfried

2011

Anaesthesist

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With increasing demands for blood transfusions, the costs and shortages, clinically relevant risks and doubts on the efficacy, blood conservation is an important issues. Among the available methods cell salvage is of great importance as it has proven effective and safe. The high availability and cost efficacy allows fast processing of at least half of the lost red blood cells. The method has wide applications in cardiac and vascular surgery, in abdominal and transplantation surgery, in orthopedics and emergency medicine, in massive hemorrhage and for Jehovah's Witnesses, and by the use of blood irradiation also in cancer surgery. Cell salvage provides autologous, washed, unstored red blood cells with unimpaired function and viability, avoiding immunological reactions and storage damage, for optimal hemotherapy. No restrictions in the indication for transfusion are necessary, thus allowing real therapy of anemia. The high quality of salvaged blood should be assured by a quality management including quality controls.

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Randomized clinical trial of intraoperative autotransfusion in surgery for abdominal aortic aneurysm

Abstract: Use of autotransfusion effectively reduced the need for HBT and was associated with a reduced incidence of postoperative SIRS and infective complications.

Cited by 43 publications

References 21 publications

Intraoperative Cell Salvage versus Allogeneic Transfusion during Abdominal Aortic Surgery: Clinical and Financial Outcomes

Intraoperative Cell Salvage versus Allogeneic Transfusion during Abdominal Aortic Surgery: Clinical and Financial Outcomes

Application of controlled hypotension combined with autotransfusion in spinal orthomorphia

Maschinelle Autotransfusion

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