Walker Lucy C, Halliwell Emma, Veitch Stephen W
Salisbury District Hospital, Salisbury, UK.
J Perioper Pract. 2023 Jul-Aug;33(7-8):239-247. doi: 10.1177/17504589221099832. Epub 2022 Jun 2.
Intraoperative cell salvage is an established method to reduce the requirement for and the volume of allogenic blood transfusion but adds to the financial cost of performing surgery.
The primary aim of this study was to determine which patients and what type of revision hip surgery benefit most from intraoperative cell salvage.
This observational study included patients who underwent revision hip surgery performed by the senior author at a single orthopaedic unit. The cohort was divided into single and two-component revision groups; then, the transfusion requirement combined with analysis of patient factors was used to create a decision-making protocol.
The two-component group had a significantly higher number of cases using cell salvage and a higher total transfusion volume. Patients who required postoperative allogenic blood transfusions had a higher mean age, were less likely to have received tranexamic acid and had a lower preoperative haemoglobin level.
Based on these results, a decision-making protocol was developed for when to use cell salvage in revision hip surgery.
术中血液回收是一种既定的减少异体输血需求和输血量的方法，但会增加手术的财务成本。
本研究的主要目的是确定哪些患者以及何种类型的髋关节翻修手术能从术中血液回收中获益最大。
这项观察性研究纳入了由资深作者在单一骨科单元进行髋关节翻修手术的患者。该队列被分为单组件和双组件翻修组；然后，结合输血需求并分析患者因素来制定决策方案。
双组件组使用血液回收的病例数显著更多，总输血量也更高。需要术后异体输血的患者平均年龄更高，接受氨甲环酸治疗的可能性更小，术前血红蛋白水平更低。
基于这些结果，制定了髋关节翻修手术中何时使用血液回收的决策方案。
