Department of Anesthesiology, Pain, & Perioperative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Obstetrics, Gynecology, & Reproductive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Anesthesiology, Pain, & Perioperative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Transfus Apher Sci. 2024 Jun;63(3):103923. doi: 10.1016/j.transci.2024.103923. Epub 2024 Apr 16.
Postpartum anemia is a significant contributor to peripartum morbidity. The utilization of cell salvage in low risk cases and its impact on postpartum anemia has not been investigated. We therefore aimed to examine the impact of autologous blood transfusion/cell salvage in routine cesarean delivery on postoperative hematocrit and anemia.
Retrospective cohort study from a perfusion database from a large academic center where cell salvage is performed at the discretion of the obstetrical team. Data from 99 patients was obtained. All patients were scheduled elective cesarean deliveries that took place on the labor and delivery floor. Thirty patients in the cohort had access to cell salvage where autologous blood was transfused after surgery. Pre-procedural hemoglobin/hematocrit measurements were obtained along will postpartum samples that were collected on post-partum day one.
The median amount of blood returned to cell salvage patients was 250 mL [206-250]. Hematocrit changes in cell salvage patients was significantly smaller than controls (-1.85 [-3.87, -0.925] vs -6.4 [-8.3, -4.75]; p < 0.001). The odds of developing new anemia following surgery were cut by 74% for the cell salvage treatment group, compared to the odds for the control group (OR = 0.26 (0.07-0.78); p = 0.028) DISCUSSION: Despite losing more blood on average, patients with access to cell salvage had higher postoperative HCT, less postpartum anemia, and no difference in complications related to transfusion. The utilization of cell salvage for routine cesarean delivery warrants further research.
产后贫血是围产期发病的重要原因。细胞回收在低危病例中的应用及其对产后贫血的影响尚未得到研究。因此，我们旨在研究在常规剖宫产中使用自体输血/细胞回收对术后血细胞比容和贫血的影响。
这是一项来自大型学术中心灌注数据库的回顾性队列研究，该中心根据产科团队的判断进行细胞回收。共获得 99 例患者的数据。所有患者均接受择期剖宫产，手术均在产房进行。队列中有 30 例患者可使用细胞回收，术后回输自体血液。术前获得血红蛋白/血细胞比容测量值，并在产后第一天采集术后样本。
细胞回收患者回输的血液中位数为 250ml[206-250]。细胞回收患者的血细胞比容变化明显小于对照组（-1.85[-3.87,-0.925]vs-6.4[-8.3,-4.75]；p<0.001）。与对照组相比，细胞回收治疗组术后新发贫血的几率降低了 74%（OR=0.26（0.07-0.78）；p=0.028）。
尽管平均失血更多，但使用细胞回收的患者术后 HCT 更高，产后贫血更少，且与输血相关的并发症无差异。细胞回收在常规剖宫产中的应用值得进一步研究。
