Hallett J W, Popovsky M, Ilstrup D
J Vasc Surg. 1987 Apr;5(4):601-6.
The purpose of this study was to determine what percentage of patients could avoid the transfusion of any homologous bank blood products during elective abdominal aortic surgery with a recently developed semicontinuous, rapid autotransfusion device. Fifty patients (26 with abdominal aortic aneurysms and 24 with aortic occlusive disease) prospectively received intraoperative autologous transfusion (group 1) and were matched for comparison with 50 patients receiving homologous blood without use of any autotransfusion equipment (group 2). For the entire perioperative period, 34 group 1 patients (68%) received only their own autotransfused blood and no other homologous blood components compared with group 2 in which 48 patients (96%) required some bank blood (p less than 0.0001). Rapid autotransfusion reduced usage of homologous red cell transfusion by 75%. The mean postoperative hemoglobin was similar in both groups (group 1, 11.91 gm/dl vs. group 2, 11.90 gm/dl, p = 0.73). Rapid autotransfusion was not associated with significant hemolysis, air embolism, or coagulopathy and did not increase morbidity or death. By eliminating the need for any bank blood components in most patients, rapid autotransfusion minimizes the risk of blood-borne diseases and transfusion reactions. New rapid autotransfusion devices offer a distinct advantage over past equipment and allow significant changes in current transfusion practices during elective abdominal aortic reconstructions.
本研究的目的是确定在择期腹主动脉手术中，使用最近开发的半连续快速自体输血装置时，有多大比例的患者可以避免输注任何同源库血制品。五十例患者（26例腹主动脉瘤患者和24例主动脉闭塞性疾病患者）前瞻性地接受了术中自体输血（第1组），并与50例未使用任何自体输血设备而接受同源血的患者进行匹配比较（第2组）。在整个围手术期，第1组中有34例患者（68%）仅接受了自身的自体输血，未接受其他同源血液成分，而第2组中有48例患者（96%）需要一些库血（p<0.0001）。快速自体输血使同源红细胞输注的用量减少了75%。两组术后平均血红蛋白水平相似（第1组为11.91g/dl，第2组为11.90g/dl，p = 0.73）。快速自体输血与显著的溶血、空气栓塞或凝血病无关，也未增加发病率或死亡率。通过消除大多数患者对任何库血成分的需求，快速自体输血将血源性疾病和输血反应的风险降至最低。新型快速自体输血装置比过去的设备具有明显优势，并允许在择期腹主动脉重建期间对当前的输血实践进行重大改变。
