Choi Ho Yong, Hyun Seung-Jae, Kim Ki-Jeong, Jahng Tae-Ahn, Kim Hyun-Jib
Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
J Korean Neurosurg Soc. 2019 Jan;62(1):53-60. doi: 10.3340/jkns.2017.0287. Epub 2018 Nov 30.
The purpose of this study was to determine the efficacy of intra-operative cell salvage system (ICS) to decrease the need for allogeneic transfusions in patients undergoing major spinal deformity surgeries.
A total of 113 consecutive patients undergoing long level posterior spinal segmental instrumented fusion (≥5 levels) for spinal deformity correction were enrolled. Data including the osteotomy status, the number of fused segments, estimated blood loss, intra-operative transfusion amount by ICS (Cell Saver®, Haemonetics©, Baltimore, MA, USA) or allogeneic blood, postoperative transfusion amount, and operative time were collected and analyzed.
The number of patients was 81 in ICS group and 32 in non-ICS group. There were no significant differences in demographic data and comorbidities between the groups. Autotransfusion by ICS system was performed in 53 patients out of 81 in the ICS group (65.4%) and the amount of transfused blood by ICS was 226.7 mL in ICS group. The mean intra-operative allogeneic blood transfusion requirement was significantly lower in the ICS group than non-ICS group (2.0 vs. 2.9 units, p=0.033). The regression coefficient of ICS use was -1.036.
ICS use could decrease the need for intra-operative allogeneic blood transfusion. Specifically, the use of ICS may reduce about one unit amount of allogeneic transfusion in major spinal deformity surgery.
本研究旨在确定术中细胞回收系统（ICS）在减少接受脊柱严重畸形手术患者同种异体输血需求方面的疗效。
共纳入113例连续接受长节段后路脊柱节段性器械融合术（≥5个节段）以矫正脊柱畸形的患者。收集并分析包括截骨情况、融合节段数、估计失血量、术中通过ICS（Cell Saver®，Haemonetics©，美国马萨诸塞州巴尔的摩）或同种异体血的输血量、术后输血量及手术时间等数据。
ICS组有81例患者，非ICS组有32例患者。两组间人口统计学数据和合并症无显著差异。ICS组81例患者中有53例（65.4%）通过ICS系统进行了自体输血，ICS组的输血量为226.7 mL。ICS组术中平均同种异体输血需求量显著低于非ICS组（2.0单位对2.9单位，p = 0.033）。使用ICS的回归系数为 -1.036。
使用ICS可减少术中同种异体输血的需求。具体而言，在脊柱严重畸形手术中使用ICS可能会减少约一个单位量的同种异体输血。
