Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.
Perfusion. 2020 Oct;35(7):574-586. doi: 10.1177/0267659119895474. Epub 2020 Feb 3.
Efforts have been made to minimize transfusion of packed red blood cells in patients undergoing cardiac surgery with cardiopulmonary bypass. One method concerns retrograde autologous priming. Although the technique has been used for decades, results remain contradictory in terms of transfusion requirements.
This systematic literature review aimed to summarize the evidence for the efficacy of retrograde autologous priming in terms of decreasing perioperative packed red blood cell requirements in adults.
Two researchers independently searched PubMed for articles published in the past 10 years. The modified Cochrane collaboration Risk of Bias Tool and the Research Triangle Institute Item Bank were used to assess bias.
Eight studies were included, of which two randomized and six observational studies. Five studies, including one randomized study, report a significant decrease in packed red blood cell use in the retrograde autologous priming group compared to no retrograde autologous priming used. All studies are flawed by at least a high risk bias of bias score on one item of the bias assessment.
Although most studies reported significantly fewer packed red blood cell transfusions in the retrograde autologous priming group, it is important to note that relatively few articles are available which are flawed by several types of bias. Prospective, randomized multi-center trials are warranted to conclude decisively on the benefits of retrograde autologous priming.
人们一直在努力减少体外循环心脏手术患者的红细胞输注。一种方法涉及逆行自体预充。尽管该技术已经使用了几十年，但在输血需求方面，结果仍然存在矛盾。
本系统文献复习旨在总结逆行自体预充在减少成人围手术期红细胞需求方面的疗效证据。
两名研究人员独立检索了过去 10 年发表的 PubMed 文章。使用改良的 Cochrane 协作风险偏倚工具和 Research Triangle Institute 项目库来评估偏倚。
共纳入 8 项研究，其中 2 项为随机对照研究，6 项为观察性研究。五项研究，包括一项随机研究，报告称与未使用逆行自体预充相比，逆行自体预充组的红细胞使用量显著减少。所有研究都至少有一个偏倚评估项目存在高风险偏倚得分的缺陷。
尽管大多数研究报告称逆行自体预充组的红细胞输注量显著减少，但需要注意的是，可用的文章相对较少，存在多种类型的偏倚。有必要进行前瞻性、随机、多中心试验，以明确逆行自体预充的益处。
