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Intraoperative cell salvage in revision hip surgery.

J M Herd1, J J Joseph1, M McGarvey1

  • 1Department of Orthopaedic Surgery, Southern General Hospital, 1345 Govan Road, Glasgow, Lanarkshire, G51 4TF, 0141 201 1100, Greater Glasgow and Clyde, United Kingdom.

Annals of Medicine and Surgery (2012)
|January 9, 2015
PubMed
Summary

Intraoperative cell salvage (ICS) significantly reduced allogeneic blood transfusions in revision hip surgery patients. This method proved effective in lowering transfusion rates and volumes, enhancing patient safety and resource management.

Keywords:
ArthroplastyBlood conservationCell-salvageIntraoperativeOrthopaedic

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Area of Science:

  • Orthopaedic Surgery
  • Transfusion Medicine
  • Patient Blood Management

Background:

  • Allogeneic blood is a limited resource with inherent risks.
  • Intraoperative cell salvage (ICS) is a potential method to reduce allogeneic transfusions in orthopaedic procedures.
  • Concerns exist regarding the efficacy and cost-effectiveness of ICS.

Purpose of the Study:

  • To evaluate the effectiveness of ICS in reducing allogeneic blood transfusions during revision hip arthroplasty.
  • To compare transfusion rates and volumes in patients undergoing revision hip surgery with and without ICS.

Main Methods:

  • Retrospective audit of patients undergoing revision hip arthroplasty at Southern General Hospital (SGH) between 2008-2010 who received ICS.
  • Comparison with a historical SGH cohort (2006-2008) and a pre-2005 control group without ICS.
  • Data collected included hemoglobin fall, re-infused blood volume, and postoperative allogeneic transfusion rates.

Main Results:

  • A 55% reduction in postoperative allogeneic transfusion proportion was observed in the 2008-2010 ICS cohort compared to the control group (p < 0.001).
  • A 40% reduction was noted compared to the previous ICS group (p < 0.001).
  • Mean units transfused per patient decreased from 3.5 (control) to 1.4 (previous ICS) to 0.8 (2008-2010 ICS cohort).

Conclusions:

  • Intraoperative cell salvage is effective in reducing the rate and volume of postoperative allogeneic transfusions in revision hip surgery.
  • Further research is required to assess the impact of anesthetic techniques on transfusion outcomes.
  • ICS demonstrates value in patient blood management for complex hip revision procedures.