Abstract
Objective: The objective of this study was to report current transfusion requirements and outcomes in patients undergoing elective aortic surgery with autologous transfusion. Methods: This was a retrospective review of transfusion practice in infrarenal aortic surgery in a tertiary vascular unit with a longstanding interest in autologous transfusion. One hundred and ten consecutive patients underwent infrarenal aortic surgery with a combination of acute normovolemic hemodilution (ANH) and intraoperative cell salvage (ICS). All patients underwent hemodilution to a target hemoglobin concentration of 11 g/dL and underwent ICS with a centrifugal device. Results: Median blood loss was 1140 mL (interquartile range [IQR], 683 to 1609 mL) in 78 aneurysm repairs and 775 mL (IQR, 400 to 1225 mL) in 32 aortobifemoral bypasses for occlusive disease (P = .02), resulting in a median salvaged red cell volume of 403 mL (IQR, 256 to 563 mL) for aneurysm repairs and 250 mL (IQR, 200 to 290 mL) in bypass surgery (P = .001). Thirty-six patients (33%) needed transfusion of stored blood, for a total of 115 units, with just four patients needing more than five units. The mortality rate was 8% (9/110). With multivariate analysis, low hemoglobin level (P = .006) and low platelet count (P = .023) were associated with stored blood transfusion. Conclusion: Blood loss is too small to justify ICS in surgery for occlusive disease; ANH alone may be a suitable strategy. With appropriate experience, the combination of ANH and ICS may render crossmatching unnecessary, even in aortic aneurysm surgery. Copyright © 2002 by The Society for Vascular Surgery and The American Association for Vascular Surgery.
Original language | English |
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Pages (from-to) | 31-34 |
Number of pages | 3 |
Journal | Journal of vascular surgery |
Volume | 36 |
Issue number | 1 |
DOIs | |
Publication status | Published - Jul 2002 |
Keywords
- Aged
- surgery: Aorta, Abdominal
- physiopathology: Aortic Aneurysm, Abdominal
- physiopathology: Aortic Aneurysm, Thoracic
- Blood Loss, Surgical
- Blood Transfusion, Autologous
- physiology: Blood Volume
- Comparative Study
- Female
- Great Britain
- Hemodilution
- analysis: Hemoglobins
- Human
- Intraoperative Care
- Male
- Middle Age
- Platelet Count
- Salvage Therapy
- Surgical Procedures, Elective
- Treatment Outcome