Intraoperative cell salvage versus postoperative autologous blood transfusion in hip arthroplasty: a retrospective service evaluation

Mason, Lyndon; Fitzgerald, Carmel; Powell-Tuck, J; Rice, R

doi:10.1308/003588411x579801

Cited by 11 publications

(8 citation statements)

References 17 publications

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“…Similar results were found by Lisander et al [12]. However, a current study by Mason et al reported that intraoperative cell salvage is the preferred method to avoid major blood loss compared to postoperative transfusion [13]. Focusing on the results in patients undergoing TKA, blood loss was neither influenced by the patient's BMI nor by the ASA score in the current cohort.…”

Section: Discussionsupporting

confidence: 84%

Effectiveness of autologous transfusion system in primary total hip and knee arthroplasty

Schneider

Kendoff

O’Loughlin

et al. 2014

THC

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BACKGROUND: Autologous transfusion has become a cost-efficient and useful option in the treatment of patients with high blood loss following major orthopaedic surgery. However, the effectiveness of autologous transfusion in total joint replacement remains controversial. OBJECTIVE: The current study analyzed the efficacy of autologous transfusion with washed shed blood (WSB) in primary total knee and total hip arthroplasty (TKA, THA). METHODS: Between January 2011 and December 2011, patients being treated with a primary TKA (n = 162) and/or THA (n = 227) and who met the inclusion criteria were recruited to the study in consecutive fashion. RESULTS: The patient age, BMI and ASA scores showed no statistically significant correlation to the degree of blood loss, quantity of autotransfusion necessary or Hb differential in TKA patients. The use of an autologous transfusion system in TKA and THA is not correlated statistically to a reduction in the amount of allogenic or autologous transfusion. CONCLUSIONS: The use of the autotransfusion system does not correlate significantly with the amount of allogenic transfusion in TKA and THA in the current authors' patient cohort. Age, BMI and ASA score appeared not to exert significant influence on the total amount of autotransfusion or Hb difference.

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Section: Discussionsupporting

confidence: 84%

Effectiveness of autologous transfusion system in primary total hip and knee arthroplasty

Schneider

Kendoff

O’Loughlin

et al. 2014

THC

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“…Especially for patients with rare blood types, patients who have been transfused with allogeneic blood and produced irregular antibodies, and patients with other blood matching problems, this technology is of great significance (53), and provides convenience for elective surgeries. The most prominent clinical features of ABT is that it can instantly provide patients with fresh blood that has identical type, quickly replenish the patient's blood volume, and improve oxygen carrying capacity (54,55), maintaining an effective blood circulation. In addition, autologous blood has low acid content and normal K + concentration, relatively higher 2,3-diphosphoglycerate levels and provides better cell vitality, preventing complications such as hyperkalemia.…”

Section: Development Trends and Challenges Of Abtmentioning

confidence: 99%

A review of the application of autologous blood transfusion

Zhou¹

2016

Braz J Med Biol Res

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Autologous blood transfusion (ABT) has been gradually attracting more attention due to the increasingly prominent problem of blood transfusion safety and blood shortage in recent years. With the rapid development of blood conservation techniques, blood component separation technology, blood transfusion medicine and a constant increase in clinical needs, ABT technology has been expanded and innovated to a large degree. In this study, the development of preoperative autologous blood donation (PABD), acute normovolemic hemodilution (ANH), intraoperative and postoperative autotransfusion, and other new technologies and theories are reviewed and existing questions are analyzed. Challenges and applications are also discussed in order to provide reference for peers.

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“…Autologous blood collection techniques, such as ICS, have been the source of debate over the last 30 years since their introduction. While the benefits of blood salvage in Orthopaedic surgery have been well described [9,21,28–32] , there remain concern that it should be used more discriminatingly. These concerns may stem from a number of studies that have shown ICS to either be ineffective or costly, across a number of other surgical specialities [2,25,33] .…”

Section: Discussionmentioning

confidence: 99%

“…As half of all units transfused in the UK are used for surgical patients [8] , a blood conservation technique like ICS seems well placed to help reduce the national use of allogenic blood. Although ICS can also be successfully carried out in knee arthroplasty, it has been shown to be less effective than ICS in hip arthroplasty [9] .…”

Section: Introductionmentioning

confidence: 99%

“…Most studies described the use of ICS in hip and knee arthroplasty patients. Several studies have shown ICS to be effective in primary hip arthroplasty [9,28] A small, case-matched study showed that ICS significantly reduced allogenic transfusion in revision hip arthroplasty [29] . Two large randomised controlled trials (RCTs) and a large retrospective database review have shown similar outcomes in Knee surgery [30–32] .…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative cell salvage in revision hip surgery

Herd¹,

Joseph²,

McGarvey³

et al. 2014

Annals of Medicine &Amp; Surgery

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Allogenic blood is a finite resource, with associated risks. Previous studies show intraoperative cell salvage (ICS) can reduce allogenic transfusion rates in orthopaedic surgery. However, there are concerns regarding efficacy and cost-effectiveness of ICS. This study was carried out to review ICS use in revision hip arthroplasty.All patients who underwent ICS and re-infusion between 2008 and 2010 in the Southern General Hospital (SGH) were audited. The fall in haemoglobin (Hb), volume of blood re-infused and postoperative allogenic transfusion rates were recorded. This group was compared to a similar SGH cohort who underwent surgery by the same surgeons between 2006 and 2008, and a pre-2005 control group where no ICS was used.The proportion of patients receiving a postoperative allogenic transfusion fell by 55% in the 2008–2010 ICS cohort compared with the control, and by 40% compared with the previous ICS group. In both instances, there was a statistically significant (p < 0.001) reduction in mean units transfused per patient; in the 2008–2010 ICS cohort, a mean of 0.8 units was used per patient, while 1.4 were used in the 2006–2008 cohort. 3.5 units were used in the control group. There was no statistically significant difference in age or preoperative Hb between the groups, or in length of hospital stay.In this study, ICS has been shown to be effective in reducing rates and volume of postoperative allogenic transfusion in patients undergoing revision hip surgery at the SGH. However, further work is needed to establish the effect of changing anaesthetic technique on postoperative allogenic transfusion rates.

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Intraoperative cell salvage versus postoperative autologous blood transfusion in hip arthroplasty: a retrospective service evaluation

Cited by 11 publications

References 17 publications

Effectiveness of autologous transfusion system in primary total hip and knee arthroplasty

Effectiveness of autologous transfusion system in primary total hip and knee arthroplasty

A review of the application of autologous blood transfusion

Intraoperative cell salvage in revision hip surgery

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