title: Efficacy, safety and user-friendliness of two devices for postoperative autologous shed red blood cell re-infusion in elective orthopaedic surgery patients: A randomized pilot study.
abstract: To determine the safety, efficacy and user-friendliness of two different postoperative autologous blood re-infusion systems, an open, randomized, controlled study was performed. Eligible consecutive primary and revision total hip and knee replacement patients were randomized for one of the two systems or for a control group in which shed blood was not re-infused. The nursing staff scored user-friendliness. Patients were monitored after re-infusion. In all three patient groups, a restrictive transfusion trigger was used. Sixty-nine of 70 randomized patients were evaluated. Ease of use, efficacy and safety of both re-infusion systems were comparable. There was no difference in allogeneic blood use between the groups. Thirty per cent of the patients re-infused with autologous blood developed a mainly mild, febrile transfusion reaction. No other adverse reactions were seen. Signs of coagulopathy after re-infusion were not found. In multivariate analysis, autologous re-infusion was an independent factor associated with a shorter hospital stay. Both postoperative autologous blood re-infusion systems were of equal efficacy and safety. The contribution of autologous wound blood re-infusion to reduce allogeneic transfusions must be investigated in a larger study.
authors.affiliation: Department of Research and Development, Sanquin Blood Bank South West Region, University Hospital, Leiden, The Netherlands. c.so@sanquin.nl
authors.forename: C
authors.initials: C
authors.lastname: So-Osman
authors.forename: R G H H
authors.initials: RG
authors.lastname: Nelissen
authors.forename: H C J
authors.initials: HC
authors.lastname: Eikenboom
authors.forename: A
authors.initials: A
authors.lastname: Brand
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D017558:Elective Surgical Procedures; D004867:Equipment Design; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D019637:Orthopedic Procedures; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods*; D019106:Postoperative Hemorrhage; D012449:Safety; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins