The volume of returned red blood cells in a large blood salvage program: where does it all go? (CME)

Waters, Jonathan H.; Dyga, Robert; Waters, Janet; Yazer, Mark H.

doi:10.1111/j.1537-2995.2011.03111.x

Cited by 48 publications

(42 citation statements)

References 24 publications

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“…Additionally, a minimum volume of blood processed has been shown to be necessary in order for ICS to be cost-effective. 25 Studies in which residual CPB contents were not processed may not have observed the cost benefit that was appreciated in the present study owing to insufficient volume of blood processed. Regardless, the significant cost savings that we observed indicates that ICS is cost-effective.…”

Section: Icsmentioning

confidence: 47%

Efficacy of intraoperative cell salvage in decreasing perioperative blood transfusion rates in first-time cardiac surgery patients: a retrospective study

et al. 2016

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Efficacy of intraoperative cell salvage in decreasing perioperative blood transfusion rates in first-time cardiac surgery patients: a retrospective study Background: Evidence regarding the safety and efficacy of intraoperative cell salvage (ICS) in transfusion reduction during cardiac surgery remains conflicting. We sought to evaluate the impact of routine ICS on outcomes following cardiac surgery. Methods: We conducted a retrospective analysis of patients who underwent non emergent, first-time cardiac surgery 18 months before and 18 months after the implementation of routine ICS. Perioperative transfusion rates, postoperative bleeding, clinical and hematological outcomes, and overall cost were examined. We used multivariable logistic regression modelling to determine the risk-adjusted effect of ICS on likelihood of perioperative transfusion. Contexte : Les résultats d'études portant sur l'innocuité et l'efficacité de l'autotransfusion peropératoire (ATPO) comme mesure de réduction du besoin de transfusion durant une chirurgie cardiaque sont contradictoires. Nous avons cherché à évaluer l'incidence du recours systématique à l'ATPO sur les issues de chirurgies cardiaques. Méthodes : Nous avons mené une analyse rétrospective portant sur des patients ayant subi une première chirurgie cardiaque non urgente 18 mois avant et 18 mois après l'introduction de l'ATPO systématique. Les taux de transfusion périopératoire et d'hémorragie postopératoire, les résultats cliniques et hématologiques et le coût total ont été analysés. Nous avons utilisé un modèle de régression logistique multivariée pour déterminer l'incidence ajustée en fonction du risque du recours à l'ATPO sur la probabilité qu'une transfusion périopératoire soit nécessaire. Résultats : L'échantillon à l'étude était composé de 389 patients (186 dans le groupe ATPO et 203 dans le groupe témoin). Par rapport au groupe témoin, les patients ayant reçu une ATPO ont eu besoin significativement moins souvent d'une transfusion de concentrés de globules rouges (33,9 % c. 45,3 %; p = 0,021), de produits coagulants (16,7 % c. 32,5 %; p < 0,001) et de produits sanguins, tous types confondus (38,2 % c. 52,7 %; p = 0,004). Chez les patients ayant reçu une ATPO, on a constaté un volume de drainage médiastinal après 12 h plus faible (moyenne : 320 mL [étendue de 230-550]

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Section: Icsmentioning

confidence: 47%

Efficacy of intraoperative cell salvage in decreasing perioperative blood transfusion rates in first-time cardiac surgery patients: a retrospective study

et al. 2016

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“…39 This technique involves the collection of shed surgical or obstetric blood and its filtration, washing, concentration and re-administration once a sufficient quantity of blood has been collected. Only surgery involving high blood loss-such as cardiac, vascular, and orthopaedic procedures-warrants it use.…”

Section: What Strategies Are In Place To Minimise Inappropriate Transmentioning

confidence: 99%

Transfusing blood safely and appropriately

Murphy

Waters

Wood

et al. 2013

BMJ

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“…22,23 Since ASB RBCs are only removed from the circulation for hours, not days or weeks, it is unlikely that storage lesions would be present. In fact, 2,3-DPG levels are thought to be normal in ASB RBCs, 24 but it is unclear how ASB and stored RBCs compare, and whether significant changes in 2,3-DPG occur in patients after receiving either ASB or stored RBCs.…”

Section: Introductionmentioning

confidence: 99%

2,3-Diphosphoglycerate Concentrations in Autologous Salvaged Versus Stored Red Blood Cells and in Surgical Patients After Transfusion

Scott

Nagababu

Johnson

et al. 2016

Anesthesia &Amp; Analgesia

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Background Stored red blood cells (RBCs) are deficient in 2,3-diphosphoglycerate (2,3-DPG), but it is unclear how autologous salvaged blood (ASB) compares to stored blood, and how rapidly 2,3-DPG levels return to normal after transfusion. Therefore, we compared levels of 2,3-DPG in stored versus ASB RBCs, and in patients’ blood following transfusion. Methods Twenty-four patients undergoing multilevel spine fusion surgery were enrolled. We measured 2,3-DPG and the oxyhemoglobin dissociation curve (P50) in samples taken from the ASB and stored blood-bags before transfusion, and in blood samples drawn from patients before and after transfusion. Results The mean storage duration for stored RBCs was 24 ± 8 days. Compared with fresh RBCs, stored RBCs had decreased 2,3-DPG levels (by ≈ 90%; P<0.0001), and a decreased P50 (by ≈ 30%; P<0.0001). However, ASB RBCs did not exhibit these changes. The mean 2,3-DPG concentration decreased by ≈ 20% (P<0.05) in postoperative blood sampled from patients who received 1 – 3 stored RBC units, and by ≈ 30% (P<0.01) in those who received ≥4 stored RBC units. 2,3-DPG was unchanged in patients who received no stored blood or ASB alone. After surgery, 2,3-DPG levels recovered gradually over three postoperative days in patients who received stored RBCs. Conclusions Stored RBCs, but not ASB RBCs, have decreased levels of 2,3-DPG and a left shift in the oxyhemoglobin dissociation curve. Postoperatively, 2,3-DPG levels remain below preoperative baseline levels for up to three postoperative days in patients who receive stored RBCs, but are unchanged in those who receive only ASB RBCs.

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The volume of returned red blood cells in a large blood salvage program: where does it all go? (CME)

Abstract: Although overall the mean volumes of RBCs returned to the patients by intraoperative blood salvage were high, the actual volumes returned depended on the case mix. There appears to be an opportunity to use blood salvage more selectively to improve efficiency.

Cited by 48 publications

References 24 publications

Efficacy of intraoperative cell salvage in decreasing perioperative blood transfusion rates in first-time cardiac surgery patients: a retrospective study

Efficacy of intraoperative cell salvage in decreasing perioperative blood transfusion rates in first-time cardiac surgery patients: a retrospective study

Transfusing blood safely and appropriately

2,3-Diphosphoglycerate Concentrations in Autologous Salvaged Versus Stored Red Blood Cells and in Surgical Patients After Transfusion

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