Smith L A, Barker D E, Burns R P
Department of Surgery, University of Tennessee School of Medicine, Chattanooga 37403, USA.
Am Surg. 1997 Jan;63(1):47-9.
The purpose of this review is to investigate the utility of autotransfusion in trauma patients in the past 3 years. A retrospective review was conducted of the charts for whom the Haemonetics Cell Saver autotransfusion device (Haemonetics Corp., Natick, MA) was utilized between January 1, 1993, and December 31, 1995. The estimated blood loss and quantity of blood transfused were noted for abdominal trauma patients. Costs of autotransfusion were then compared to estimated blood bank costs for this group. The Haemonetics Cell Saver autotransfusion device was requested for 592 cases from January 1, 1993, to December 31, 1995. Nonorthopedic trauma cases comprised 25 per cent of all autotransfusion cases. One hundred twenty-six patients had isolated abdominal trauma and had a mean estimated blood loss of 4864 +/- 6070 cc. The average volume of intraoperatively salvaged autologous blood transfused (autotransfusion) per patient was 1547 +/- 2359 cc, or a bank blood equivalent of 6.9 units of packed red blood cells. The total cost of autotransfusion in these patients was $63,252.00. Had bank blood been used instead of salvaged autologous blood, the cost would have been $114,523.00; thus, autotransfusion resulted in a savings of $51,271.00. The use of salvaged autologous blood comprised 45 per cent of total blood transfused. On a case-by-case basis, 75 per cent of cases were cost-effective compared to blood bank costs for an equivalent transfusion. Transfusion of intraoperatively salvaged autologous blood (autotransfusion) is a cost-effective, efficient way to provide blood products to operative trauma patients.
本综述的目的是调查过去3年中自体输血在创伤患者中的应用价值。对1993年1月1日至1995年12月31日期间使用海莫奈蒂克斯血液回收自体输血装置(海莫奈蒂克斯公司,马萨诸塞州纳蒂克)的病历进行了回顾性研究。记录了腹部创伤患者的估计失血量和输血量。然后将自体输血的成本与该组估计的血库成本进行比较。1993年1月1日至1995年12月31日期间,共申请使用海莫奈蒂克斯血液回收自体输血装置592例。非骨科创伤病例占所有自体输血病例的25%。126例患者为单纯腹部创伤,平均估计失血量为4864±6070毫升。每位患者术中回收的自体输血平均输血量为1547±2359毫升,相当于6.9单位浓缩红细胞的血库血量。这些患者自体输血的总成本为63252.00美元。如果使用血库血液而非回收的自体血液,成本将为114523.00美元;因此,自体输血节省了51271.00美元。回收的自体血液使用量占总输血量的45%。逐例分析,与血库同等输血成本相比,75%的病例具有成本效益。术中回收自体血液(自体输血)是为手术创伤患者提供血液制品的一种具有成本效益且高效的方式。