Intraoperative autotransfusion is associated with modest reduction of allogeneic transfusion in prosthetic hip surgery
Intraoperative autotransfusion is associated with modest reduction of allogeneic transfusion in prosthetic hip surgery
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DOI：
10.1111/j.1399-6576.1998.tb05305.x
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发表时间：
1998-07-01
影响因子：
2.1
通讯作者：
Jacobsson, SA
中科院分区：
文献类型：
--
作者：
Lisander, B;Ivarsson, I;Jacobsson, SA
背景资料：术中抢救和洗涤伤口的血液和异基因红细胞输注在假体hip surgery.Methods中的预测因子的疗效是不充分knowed：在96例患者，接受初级或翻修手术，抢救和洗涤红细胞，如果必要的话，异基因血被用来保持红细胞压积不低于33%。根据红细胞平衡计算住院期间的红细胞出血。估计术前红细胞储备（超过红细胞压积33%的红细胞毫升数），并回顾性使用该体积与红细胞总出血量之间的差异对患者红细胞需求进行分类。逐步回归分析被用来定义患者相关的变量与同种异体bloodtransfusion.Results：术前知识的类型的操作（主要，修订），术前红细胞储备，和身体质量可以预测大约一半的需要库血（r（2）=0.45）。只有三分之一的红细胞被回输。对于完全避免异体血，自体输血是最有效的患者中度需要（0-4 u）。然而，32%的此类患者需要异基因blood.Conclusions：自体输血的疗效有限，以减少对异基因血液的需要，并应增加其他血液节约的方法。术前很难预测是否需要异体血。
Background: The efficacy of intraoperative salvage and washing of wound blood and the predictors of allogeneic red cell transfusions in prosthetic hip surgery are insufficiently known.Methods: In 96 patients, undergoing primary or revision surgery, salvaged and washed red cells and, if necessary, allogeneic blood were used to keep haematocrit not lower than 33%. The bleeding of red cells during hospital stay was calculated from the red cell balance. The preoperative red cell reserve (millilitres of red cells in excess of a haematocrit of 33%) was estimated and the difference between this volume and the total bleeding of red cells was retrospectively used to classify patients with regard to the need for red cells. Stepwise regression analysis was used to define patient-related variables associated with allogeneic blood transfusion.Results: Preoperative knowledge of the type of operation (primary, revision), the preoperative red cell reserve, and the body mass could predict roughly half of the need for banked blood (r(2)=0.45). Only one-third of the total bleeding of red cells was retransfused. For complete avoidance of allogeneic blood, autotransfusion was most effective in patients with a moderate need (0-4 u). However, 32% of such patients required allogeneic blood.Conclusions: Autotransfusion has a limited efficacy to decrease the need for allogeneic blood, and other blood-saving methods should be added for this purpose. It is difficult to predict the need for allogeneic blood preoperatively.