Intraoperative autologous blood transfusion in intracranial surgery.
OBJECTIVE
The purpose of this study was to evaluate the benefits of intraoperative autotransfusion of autologous blood on the conservation of allogenic blood, including cost-effectiveness and the consequences for hemoglobin level and coagulation tests.


METHODS
The Hoemonetics Cell Saver 4 autotransfusion system (Hoemonetics Corporation, MA) was used when the estimated blood loss was equal to or more than 500 ml. A total of 472 patients undergoing intracranial surgery were included in the study.


RESULTS
Ninety patients (19%) received transfusions either with autologous blood or allogenic blood. Fifty-five patients (61%) received only autologous blood transfusions, 10 patients (11%) received both autologous and allogenic blood transfusions, and 25 patients (28%) received only allogenic blood transfusions. The amount of autologous blood transfused was 600 +/- 590 ml (range, 230-3000 ml). The amount of allogenic blood transfused was 3 +/- 3 units (range, 2-15 units). Autologous blood represented 68% of all blood products transfused. Mild abnormalities during coagulation tests occurred without clinical bleeding.


CONCLUSIONS
Autologous blood transfusions were demonstrated to be safe in patients undergoing intracranial surgery and to be more cost-effective than allogenic blood transfusions. Intraoperative autologous blood transfusions may be used alone in more than half of the patients requiring transfusions during intracranial surgery and decrease the amount of allogenic blood used. Improvements in the monitoring for the need of performing this technique, as well as preoperative blood donations, would decrease the amount of allogenic blood transfused.
Cataldi
S
S
Département d'Anesthésie Réanimation, CHU Timone Adultes, Marseille,France.
Bruder
N
N
Dufour
H
H
Lefevre
P
P
Grisoli
F
F
François
G
G
D000328:Adult; D001780:Blood Coagulation Tests; D001787:Blood Group Incompatibility / Q000517:prevention & control; D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data; D001932:Brain Neoplasms / Q000097:blood / Q000601:surgery*; D003362:Cost-Benefit Analysis; D017558:Elective Surgical Procedures; D005260:Female; D005602:France; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D017053:Infection Control; D002532:Intracranial Aneurysm / Q000097:blood / Q000601:surgery; D007430:Intraoperative Care / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008577:Meningeal Neoplasms / Q000097:blood / Q000601:surgery; D008579:Meningioma / Q000097:blood / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D065227:Transfusion Reaction
D006454:Hemoglobins