Toward the Elimination of Homologous Blood Use in Elective Lumbar Spine Surgery

Seltzer, Dana G.; Brown, Mark D.; Tompkins, Janet; Enger, Isadore; Cammisa, Frank P.

doi:10.1097/00002517-199306050-00008

Cited by 12 publications

(6 citation statements)

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“…These findings corresponded with those of previous reports. 3,15,20,22,27 However, no significant correlation was found between blood loss and transfusion.…”

Section: Multiple Regression Analysismentioning

confidence: 97%

Factors Predicting Hospital Stay, Operative Time, Blood Loss, and Transfusion in Patients Undergoing Revision Posterior Lumbar Spine Decompression, Fusion, and Segmental Instrumentation

Zheng

Cammisa

Sandhu

et al. 2002

Spine

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310

170

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“…These findings corresponded with those of previous reports. 3,15,20,22,27 However, no significant correlation was found between blood loss and transfusion.…”

Section: Multiple Regression Analysismentioning

confidence: 97%

Factors Predicting Hospital Stay, Operative Time, Blood Loss, and Transfusion in Patients Undergoing Revision Posterior Lumbar Spine Decompression, Fusion, and Segmental Instrumentation

Zheng

Cammisa

Sandhu

et al. 2002

Spine

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310

170

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“…Seltzer et al reviewed 224 adults who had mixed procedures. 15 They used IAT in cases where there was an anticipated high blood loss, and nearly all patients predonated blood. The combined use of the two was able to cover transfusion needs in 96%, including 94% of the fusions.…”

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confidence: 99%

The Cell Saver in Adult Lumbar Fusion Surgery

Reitman¹,

Watters²,

Sassard³

2004

Spine

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There was a 38% recovery rate of blood using the Cell Saver. This resulted in a decreased need for postoperative transfusion in the study group (1 U to 36% of patients) relative to the control group (1 U to 50% of patients). Significant predictors for surgery time were the number of levels fused (P < 0.0001), patient's weight (P = 0.0030), and use of Cell Saver (P = 0.0472). Significant indicators of blood loss were the number of levels fused (P < 0.0001) and surgical time (P = 0.0304). The average cost for blood-related charges in the Cell Saver group was 512 dollars versus 270 dollars per patient in the control group. CONCLUSIONS.: While the Cell Saver group did require fewer postoperative transfusions, the difference was not as much as expected. In elective fusions for degenerative conditions of the lumbar spine, blood requirements can usually be satisfied with predonation of autologous blood. With contemporary practices of predonation, the use of the Cell Saver appears to be neither necessary nor cost-effective during most elective lumbar fusions.

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“…vertebral fusions) but also in adolescents (e.g. scoliosis surgery) (Table 5) [4,8,9,11,13,17,18,19,22]. Data from our series showed that PABD avoided exposure to ABT in almost 80% of the patients, even though PABD was far more effective in fusions (85.7%) than in scoliosis (47.8%) ( Table 2).…”

Section: Discussionmentioning

confidence: 78%

“…Thus, these data clearly indicate the need to associate other blood saving methods (e.g. perioperative blood salvage, haemostatic drugs or EPO) with PABD in scoliosis [4,7,9,11,12,13,16,17,18,21,22,29].…”

Section: Discussionmentioning

confidence: 89%

Predeposit autologous donation in spinal surgery: a multicentre study

et al. 2004

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IntroductionAllogeneic blood transfusions (ABT) are often necessary in elective spine surgery because of perioperative blood loss. However, ABTs are not a risk-free therapy as they carry the potential risk of viral disease transmission, bacterial contamination, incompatibility reactions or transfusion-related immunomodulation (TRIM) [4]. The TRIM effect has been particularly implicated in the increased postoperative infection rate observed in patients who received ABT [6,25,26,27,28].Autologous blood transfusion (AUT) techniques have emerged as the principal means to avoid or reduce the need for ABT. These techniques involve the collection and reinfusion of the patient's own blood by using preoperative autologous blood donation (PABD), preoperative acute normovolaemic haemodilution, intraoperative salAbstract Background. Allogeneic blood transfusions (ABT) are often necessary in elective spine surgery because of perioperative blood loss. Preoperative autologous blood donation (PABD) has emerged as the principal means to avoid or reduce the need for ABT. Consequently, a multicentre study was conducted to determine the yield and efficacy of PABD in spine surgery and the possible role of recombinant human erythropoietin (EPO) in facilitating PABD. Methods. We retrospectively reviewed the hospital charts and blood bank records from all consecutive spine surgery patients who were referred for PABD. Data were obtained from two A-category hospital blood banks and one general hospital. Although we collected data from 1994, the analytic study period was from the last quarter of 1995 to December 2003. Fifty-four (7%) out of 763 patients referred for PABD were rejected, and medical records were available for 680 patients who were grouped into spinal fusion (556; 82%) and scoliosis surgery (124;18%). EPO was administered to 120 patients (17.6%). From 1999 to 2003, PABD steadily increased from 60 to 209 patients per year. Results. Overall, 92% of the patients were able to complete PABD, 71% were transfused, and almost 80% avoided ABT. PABD was more effective in fusions (86%) than in scoliosis (47%). Blood wastage was 38%, ranging from 18% for scoliosis to 42% for fusions. EPO allowed the results in the anaemic patients to be improved. Conclusions. Therefore, despite the limitations of this retrospective study, we feel that PABD is an excellent alternative to ABT in spine surgery. However, the effectiveness of PABD may be enhanced if associated with other blood-saving techniques.

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Toward the Elimination of Homologous Blood Use in Elective Lumbar Spine Surgery

Cited by 12 publications

References 0 publications

Factors Predicting Hospital Stay, Operative Time, Blood Loss, and Transfusion in Patients Undergoing Revision Posterior Lumbar Spine Decompression, Fusion, and Segmental Instrumentation

Factors Predicting Hospital Stay, Operative Time, Blood Loss, and Transfusion in Patients Undergoing Revision Posterior Lumbar Spine Decompression, Fusion, and Segmental Instrumentation

The Cell Saver in Adult Lumbar Fusion Surgery

Predeposit autologous donation in spinal surgery: a multicentre study

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