Pabón-Carrasco Manuel, Cáceres-Matos Rocío, Martínez-Flores Salvador, Luque-Oliveros Manuel
Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009, Sevilla, Spain.
"CTS-1054: Interventions and Health Care, Red Cross (ICSCRE)", Spain.
Heliyon. 2024 Apr 27;10(9):e30459. doi: 10.1016/j.heliyon.2024.e30459. eCollection 2024 May 15.
Alternatives to allogeneic blood transfusions are sought for resource management reasons and it is necessary to investigate the efficiency and efficacy on Cell Salvage use. The objective of this study is to analyze the effectiveness of the Cell Salvage system in addressing factors related to healthcare service utilization that may lead to increased healthcare expenditure.
A systematic review with meta-analysis was conducted through literature search in Medline, CINAHL, Scopus, Web of Science, and Cochrane Library. Inclusion criteria were studies in English/Spanish, without year restriction and Randomized Controlled Trials design, conducted in adults.
Twenty-six studies were included in the systematic review, involving a total of 4781 patients (n = 2365; n = 2416). Significant differences favored the Cell Salvage system in units of transfused Red Blood Cells, in terms of units (p = 0.04; SMD = -0.42 95 % CI = -0.83 to -0.02) and individuals (p = 0.001; RR = 0.71, 95 % CI = 0.60 to 0.84) transfused. No significant differences were found in ICU (p = 0.93) and hospital stay duration (p = 0.21), number of reoperations (p = 0.68), and number of units and individuals transfused in terms of platelets (p > 0.05).
Cell Salvage use holds high potential for reducing healthcare costs and indirectly contributing to improving blood and blood product reserves within blood banks. Results obtained thus far do not provide definitive evidence regarding the duration of hospital stay, ICU stay, need for reoperation, or the quantity of transfused platelets. Therefore, it is recommended to increase the number of studies to assess the impact on the economic models of the Cell Salvage system.
出于资源管理的原因，人们正在寻求异体输血的替代方法，有必要研究细胞回收利用的效率和效果。本研究的目的是分析细胞回收系统在解决可能导致医疗保健支出增加的与医疗服务利用相关因素方面的有效性。
通过在Medline、CINAHL、Scopus、Web of Science和Cochrane图书馆进行文献检索，进行了一项系统评价和荟萃分析。纳入标准为以英语/西班牙语发表的研究，无年份限制，采用随机对照试验设计，研究对象为成年人。
系统评价纳入了26项研究，共涉及4781例患者（n = 2365；n = 2416）。在输注红细胞单位方面，细胞回收系统有显著差异，在单位（p = 0.04；标准化均值差 = -0.42，95%置信区间 = -0.83至-0.02）和个体（p = 0.001；相对危险度 = 0.71，95%置信区间 = 0.60至0.84）输注方面均如此。在重症监护病房（p = 0.93）、住院时间（p = 0.21）、再次手术次数（p = 0.68）以及血小板输注的单位数和个体数方面未发现显著差异（p > 0.05）。
细胞回收利用在降低医疗成本以及间接有助于改善血库中的血液和血液制品储备方面具有很大潜力。迄今为止获得的结果并未提供关于住院时间、重症监护病房停留时间、再次手术需求或血小板输注量的确切证据。因此，建议增加研究数量以评估细胞回收系统对经济模型的影响。
