Document Detail


Transfusion of cell saver salvaged blood in neonates and infants undergoing open heart surgery significantly reduces RBC and coagulant product transfusions and donor exposures: results of a prospective, randomized, clinical trial.
MedLine Citation:
PMID:  23287903     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate whether transfusion of cell saver salvaged, stored at the bedside for up to 24 hrs, would decrease the number of postoperative allogeneic RBC transfusions and donor exposures, and possibly improve clinical outcomes.
DESIGN: Prospective, randomized, controlled, clinical trial.
SETTING: Pediatric cardiac intensive care unit.
PATIENTS: Infants weighing less than 20 kg (n = 106) presenting for cardiac surgery with cardiopulmonary bypass.
INTERVENTIONS: Subjects were randomized to a cell saver transfusion group where cell saver blood was available for transfusion up to 24 hrs after collection, or to a control group. Cell saver subjects received cell saver blood for volume replacement and/or RBC transfusions. Control subjects received crystalloid or albumin for volume replacement and RBCs for anemia. Blood product transfusions, donor exposures, and clinical outcomes were compared between groups.
MEASUREMENTS AND MAIN RESULTS: Children randomized to the cell saver group had significantly fewer RBC transfusions (cell saver: 0.19 ± 0.44 vs. control: 0.75 ± 1.2; p = 0.003) and coagulant product transfusions in the first 48 hrs post-op (cell saver: 0.09 ± 0.45 vs. control: 0.62 ± 1.4; p = 0.013), and significantly fewer donor exposures (cell saver: 0.60 ± 1.4 vs. control: 2.3 ± 4.8; p = 0.019). This difference persisted over the first week post-op, but did not reach statistical significance (cell saver: 0.64 ± 1.24 vs. control: 1.1 ± 1.4; p = 0.07). There were no significant clinical outcome differences.
CONCLUSION: Cell saver blood can be safely stored at the bedside for immediate transfusion for 24 hrs after collection. Administration of cell saver blood significantly reduces the number of RBC and coagulant product transfusions and donor exposures in the immediate postoperative period. Reduction of blood product transfusions has the potential to reduce transfusion-associated complications and decrease postoperative morbidity. Larger studies are needed to determine whether this transfusion strategy will improve clinical outcomes.
Authors:
Jill M Cholette; Karen S Powers; George M Alfieris; Ronald Angona; Kelly F Henrichs; Debra Masel; Michael F Swartz; L Eugene Daugherty; Kevin Belmont; Neil Blumberg
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  14     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-07     Completed Date:  2013-09-16     Revised Date:  2014-02-04    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  137-47     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Blood Transfusion, Autologous*
C-Reactive Protein / metabolism
Cardiopulmonary Bypass*
Erythrocyte Transfusion
Female
Heart Defects, Congenital / surgery*
Humans
Infant
Infant, Newborn
Intraoperative Care
Male
Operative Blood Salvage*
Plasma
Platelet Transfusion
Postoperative Care
Treatment Outcome
Grant Support
ID/Acronym/Agency:
R01 HL095467/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
9007-41-4/C-Reactive Protein
Comments/Corrections
Comment In:
Pediatr Crit Care Med. 2013 Feb;14(2):224-5   [PMID:  23388570 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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