| Efficacy of intraoperative cell salvage systems in pediatric idiopathic scoliosis patients undergoing posterior spinal fusion with segmental spinal instrumentation. | |
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MedLine Citation:
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PMID: 20081521 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY DESIGN: Retrospective case-control study. OBJECTIVE: Determine whether intraoperative cell salvage system use during pediatric posterior spinal fusion (PSF) with segmental spinal instrumentation for idiopathic scoliosis decreases intraoperative and perioperative (intraoperative plus postoperative) allogeneic blood transfusion. SUMMARY OF BACKGROUND DATA: Intraoperative cell salvage and reinfusion can reduce or obviate perioperative allogeneic blood transfusion. Despite these benefits, their efficacy in pediatric PSF is unclear. Reported complications include transient hematuria, altered hemostasis, and electrolyte imbalance. METHODS: A total of 54 consecutive idiopathic scoliosis patients were studied: 21 non-cell saver and 33 cell saver patients. Data included age, body mass index, Cobb angle, perioperative hemoglobin levels, mean arterial pressure, surgical time, levels fused, perioperative estimated blood loss, and perioperative transfusions. A chi2 and t tests were performed for intraoperative and perioperative allogeneic transfusion between groups. A regression analysis was performed between selected covariates and allogeneic transfusion. Relative risk analysis examined significant covariates regarding allogeneic transfusion rate. RESULTS: Allogeneic transfusion rates were lower in the cell saver group (6% vs. 55% intraoperative and 18% vs. 55% perioperative, P < 0.05). Mean allogeneic transfusion volumes (mL/kg) were also lower (0.4 vs. 9.1 intraoperative and 1.9 vs. 11.1 perioperative, P < 0.05). Multivariate analysis confirmed these differences were independent of perioperative blood loss, and also demonstrated that surgical time and blood loss were significantly related to allogeneic transfusion volume. The allogeneic transfusion relative risk was 2.04 in patients with surgery >6 hours and 5.87 in patients not receiving cell saver blood. All patients with surgeries >6 hours and estimated blood loss >30% of total blood volume received cell saver system blood. CONCLUSION: Cell saver use decreased allogeneic transfusion, particularly in surgeries >6 hours with estimated blood loss >30% of total blood volume. This study confirms the utility of routine cell saver use during PSF with segmental spinal instrumentation for idiopathic scoliosis. |
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Authors:
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Richard E Bowen; Steven Gardner; Anthony A Scaduto; Michael Eagan; Jason Beckstead |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Spine Volume: 35 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-01-18 Completed Date: 2010-03-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
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Languages: eng Pagination: 246-51 Citation Subset: IM |
Affiliation:
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Shriners Hospitals for Children, Los Angeles, USA. rbowen@laoh.ucla.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Blood Transfusion, Autologous / adverse effects* Case-Control Studies Chi-Square Distribution Child Female Humans Intraoperative Period Length of Stay Male Multivariate Analysis Retrospective Studies Scoliosis / surgery* Spinal Fusion / adverse effects*, instrumentation Spine / surgery* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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