Weiss Jennifer M, Skaggs David, Tanner John, Tolo Vernon
Children's Orthopaedic Center, Children's Hospital-Los Angeles, 4650 Sunset Boulevard, Mailstop #69, Los Angeles, CA, 90027, USA,
J Child Orthop. 2007 Oct;1(4):221-7. doi: 10.1007/s11832-007-0032-6. Epub 2007 Jul 10.
Review of the use of Cell Saver in a non-randomized group of patients undergoing spinal fusion for scoliosis.
To determine the efficacy of the use of Cell Saver for spinal fusions for scoliosis. Although Cell Saver is widely used in scoliosis surgery, it is not clear whether its use decreases the need for other transfusions or whether there are certain patients more likely to benefit from its use. The blood collected by Cell Saver intraoperatively is not always of sufficient volume to be returned to the patient, and there are no current guidelines addressing the amount that is likely to be returned to the patient.
The purpose of this study was to determine: Does use of Cell Saver reduce the need for other transfusions in scoliosis surgery? Is there an amount of blood loss at which Cell Saver is likely to be returned?
The study group consisted of 95 children who had undergone posterior spinal fusion between January 2002 and March 2004 with one of two surgeons. One surgeon used Cell Saver, the other surgeon did not. Of the total, 58 patients who underwent posterior spinal fusion with the use of Cell Saver (group 1) were compared with the 37 (group 2) who underwent the same procedure without the use of Cell Saver.
Of those in group 1, 34 received Cell Saver blood back as an intraoperative autologous transfusion (IAT) (59%). Patients in the Cell Saver group were just as likely to receive non-Cell Saver transfusions as those in the control group (P = 0.12). Of the 39 patients who lost more than 500 cc of blood, 34 received IAT (87%). No patient who lost less than 500 cc of blood received IAT.
The use of Cell Saver does not reduce the need for other transfusions in scoliosis surgery. The amount of blood loss at which Cell Saver is likely to be returned is 500 cc. We demonstrated no benefit in the use of Cell Saver in our patient population.
回顾在一组非随机的脊柱侧弯患者中使用血液回收机的情况，这些患者接受了脊柱融合手术。
确定血液回收机在脊柱侧弯脊柱融合手术中的疗效。尽管血液回收机在脊柱侧弯手术中广泛使用，但尚不清楚其使用是否减少了对其他输血的需求，或者是否有某些患者更可能从其使用中受益。血液回收机术中收集的血液量并不总是足以回输给患者，并且目前没有关于可能回输给患者的血量的指南。
本研究的目的是确定：血液回收机的使用是否减少了脊柱侧弯手术中对其他输血的需求？是否存在一个失血量，在该失血量时血液回收机可能会回输血？
研究组由95名儿童组成，他们在2002年1月至2004年3月期间由两名外科医生之一进行了后路脊柱融合手术。一名外科医生使用血液回收机，另一名外科医生未使用。总共，将58例使用血液回收机进行后路脊柱融合手术的患者（第1组）与37例（第2组）未使用血液回收机进行相同手术的患者进行比较。
在第1组中，34例接受了血液回收机回收的血液作为术中自体输血（IAT）（59%）。血液回收机组的患者接受非血液回收机输血的可能性与对照组患者相同（P = 0.12）。在39例失血量超过500 cc的患者中，34例接受了IAT（87%）。失血量少于500 cc的患者均未接受IAT。
血液回收机的使用并未减少脊柱侧弯手术中对其他输血方法的需求。血液回收机可能回输血的失血量为500 cc。我们证明在我们的患者群体中使用血液回收机没有益处。
