Brown C N, Hakim C, Sayers R D, London N J M, Nasim A
Department of Vascular and Endovascular Surgery, Leicester Royal Infirmary, Leicester, UK.
Ann Vasc Surg. 2011 May;25(4):481-4. doi: 10.1016/j.avsg.2010.11.017.
Allogeneic blood products have become a limited and expensive resource. The Continuous Autotransfusion System (CATS) has been promoted as a method for reducing the need for allogeneic blood transfusion. This study was undertaken to ascertain whether the use of CATS in emergency open AAA surgery has any benefits.
This is a retrospective study of all patients undergoing emergency open AAA surgery in our center during a 5-year period (between July 2004 and July 2009). Patients were identified from a prospectively maintained vascular database, and data were obtained from patient records.
CATS was used in 69 emergency open AAA repairs. The median total blood loss was 3,500 mL (range: 751-13,796 mL) but the median volume of packed red blood cells produced by CATS was only 493 mL (~ 2 U). An average of 7 U (range: 0-19 U) of bank blood was still used despite the availability of CATS. The mean hemoglobin 24 hours postoperatively was 10.3 g/dL (6.4-14.1) with a hematocrit of 0.30.
The use of CATS in emergency AAA surgery does not seem to reduce the use of allogeneic blood transfusion. This may be because of over transfusion, as reflected by relatively high postoperative hemoglobin levels.
同种异体血制品已成为一种有限且昂贵的资源。连续自体输血系统（CATS）已被推广为一种减少同种异体输血需求的方法。本研究旨在确定在急诊开放性腹主动脉瘤手术中使用CATS是否有任何益处。
这是一项对我们中心在5年期间（2004年7月至2009年7月）接受急诊开放性腹主动脉瘤手术的所有患者的回顾性研究。患者从前瞻性维护的血管数据库中识别出来，数据从患者记录中获取。
69例急诊开放性腹主动脉瘤修复手术使用了CATS。总失血量中位数为3500 mL（范围：751 - 13796 mL），但CATS产生的浓缩红细胞中位数体积仅为493 mL（约2单位）。尽管有CATS可用，但平均仍使用了7单位（范围：0 - 19单位）的库存血。术后24小时平均血红蛋白为10.3 g/dL（6.4 - 14.1），血细胞比容为0.30。
在急诊腹主动脉瘤手术中使用CATS似乎并未减少同种异体输血的使用。这可能是由于过度输血，术后血红蛋白水平相对较高反映了这一点。
