Background Intraoperative autologous transfusion (IAT) has been used in scoliosis surgery for decades; however, its cost-effectiveness remains debatable. This study aimed to evaluate the cost-effectiveness of IAT in adolescent idiopathic scoliosis (AIS) surgery and identify risk factors of massive intraoperative blood during this surgery. Methods The medical records of 402 patients who underwent AIS surgery were reviewed. The patients were divided into different groups according to the intraoperative blood loss volume (group A: ≥500 to < 1000 mL, B: ≥1,000 to < 1,500 mL, and C: ≥1,500 mL) and whether IAT was used (i.e., IAT and no-IAT groups). The volume of blood loss, volume of transfused allogeneic red blood cells (RBC), and RBC transfusion costs were analysed. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors of massive intraoperative blood loss (≥ 1,000 mL and ≥ 1,500 mL). A receiver operating characteristic (ROC) curve was used to analyse the cut-off values of the factors contributing to massive intraoperative blood loss. Results In group A, no significant difference was observed in the volume of allogeneic RBC transfused during and after procedure between the IAT and no-IAT groups; however, total RBC transfusion costs was significantly higher in the IAT group. In groups B and C, the patients in the IAT group compared with those in the no-IAT group had a lower volume of allogeneic RBC transfused during the operation and on the first day after the operation. However, in group B, the total RBC transfusion cost in the patients who used IAT was significantly higher. In group C, total RBC transfusion cost in the patients who used IAT was significantly lower. The number of fused vertebral levels and Ponte osteotomy were found to be independent risk factors for massive intraoperative blood loss. ROC analysis showed that more than eight and 10 fused vertebral levels predicted ≥ 1,000 mL and ≥ 1,500 mL intraoperative blood loss, respectively. Conclusion The cost-effectiveness of IAT in AIS was related to the volume of blood loss, and when the blood loss volume was ≥ 1,500 mL, IAT was cost-effective, drastically reducing the demand for allogeneic RBC and total RBC transfusion cost. The number of fused vertebral levels and Ponte osteotomy were independent risk factors for massive intraoperative blood loss.
Background: Intraoperative autologous transfusion(IAT) has been used in scoliosis surgery for decades; however, its cost-effectiveness remains debatable. Therefore, this study aimed to evaluate the cost-effectiveness of IAT in adolescent idiopathic scoliosis (AIS) surgery with different blood loss volumes. Methods: The medical records of 402 patients who underwent AIS surgery were reviewed. Depending on the volume of blood lost during the operation, the patients were divided into three groups: A (≥500 to <1000 mL), B (≥1,000 to <1,500 mL), and C (≥1,500mL). Depending on whether IAT was used, each group was further divided into the IAT and no-IAT groups. The volume of blood loss, volume of transfused allogeneic red blood cells (RBC),and RBC transfusioncosts were analyzed.Univariate and multivariate logistic regression analyses were used to identify the independent risk factors of massive intraoperative blood loss (≥1,000 mL and ≥1,500 mL). A receiver operating characteristic (ROC) curve was used to analyze the cutoff values of the factors contributing to massive intraoperative blood loss. Results: In group B, the IAT group had a lower volume of allogeneic RBC transfused than the no-IAT group, whereas the total RBC transfusion cost in the IAT group was significantly higher than that in the no-IAT group. In group C, the volume of allogeneic RBC transfused in the IAT group reduced significantly more than that in the no-IAT group. The number of vertebral levels fused was found to be an independent risk factor for massive intraoperative blood loss. Conclusion: The cost-effectiveness of IAT in AIS is related to the volume of blood lost. The number of fused vertebral levels is an independent risk factor that can effectively predict massive intraoperative blood loss.
Transition heat adjustment of CaCl2·6H2O added small quantity of stable additives (Ba (OH)2 and SrCl2·6H2O) was investigated by means of adding excess water. The experimental investigation results showed that, the transition heat adjustment of CaCl2·6H2O could be realized by adding excess water. With regard to CaCl2·6H2O, the suitable adjustment range of transition heat was 170kJ/kg-191.2kJ/kg as the proportion of adding excess water was 0-12.5% by weight; during the suitable adjustment range of transition heat, the phase change material with a random transition heat could be prepared by adding suitable excess water according to the actual requirement, and the transition heat of CaCl2·6H2O with different proportion of excess water could be forecasted. It is very beneficial for temperature and heat control in greenhouse.
Since phase change energy storage exchanger has two functions of heat exchange and heat energy storage, it is an important component of heat energy storage technique with phase change materials, its research has been thought highly by people, and great achievements have been obtained during the recent years. A review on its various structures and their research and development was made in this paper, and its further research and applications were also analyzed and forecasted.
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