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Utility of Cell Saver in Trauma Compared to Cardiac Surgery
Brandon R Couch1, Eunjee Kim1, Kripa Shrestha1
1Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
Insights
Cellsaver (CS) device use is common in cardiac surgery but less frequent in trauma. Despite lower success rates in trauma, CS offers a net benefit, salvaging a median of one unit of blood, making it cost-effective in many trauma centers.
Area of Science:
- Medicine
- Surgical Innovation
- Blood Transfusion
Background:
- Reperfusion of autologous blood using the Cellsaver (CS) device is standard in cardiothoracic surgery.
- There is limited evidence supporting the use of Cellsaver in trauma patients.
Purpose of the Study:
- To compare the utility and effectiveness of the Cellsaver device in cardiothoracic surgery versus trauma surgery.
- To evaluate the cost-effectiveness of Cellsaver in trauma settings.
Main Methods:
- Retrospective review of Cellsaver usage data from 2017 to 2022 at a Level 1 trauma center.
- Comparison of Cellsaver success rates and blood volume salvaged between cardiac surgery and trauma cases (general and orthopedic).
Main Results:
- Cellsaver was successfully used in 97% of cardiac cases and 74% of trauma cases.
- The proportion of blood requirements met by Cellsaver was higher in cardiac surgery compared to trauma.
- A median of one unit of blood was salvaged by Cellsaver in both general and orthopedic trauma cases.
Conclusions:
- Cellsaver demonstrates utility in trauma surgery, providing a net benefit by salvaging blood volume.
- The use of Cellsaver in trauma operations should be considered in centers where its setup cost is less than the cost of a single allogeneic blood unit.
Abstract:
While reperfusion of autologous blood using the Cellsaver (CS) device is routine in cardiothoracic surgery, there is a paucity of evidence-based literature regarding its use in trauma. Utility of CS was compared in these two distinct populations at a Level 1 trauma center from 2017 to 2022. CS was successfully used in 97% and 74% of cardiac and trauma cases, respectively. The proportion of blood requirements provided by CS, compared to allogenic transfusion, was also significantly higher in cardiac surgery. However, there was still net benefit for CS in trauma surgery, with median salvaged transfusion volume of one unit, in both general & orthopedic trauma. Therefore, in centers where the cost of setting up CS, both in terms of equipment and personnel, is less than the cost of one unit of blood from blood bank, use of CS in trauma operations should be considered.
