Efficacy of intraoperative cell saver in decreasing postoperative blood transfusions in instrumented posterior lumbar fusion patients.
METHODS
A retrospective study.


OBJECTIVE
To determine the efficacy of using intraoperative cell saver in decreasing the need for blood transfusion.


BACKGROUND
Lumbar spine surgery is associated with potential large intraoperative blood loss, which may put patients at risk for blood transfusions. Preoperative autologous blood donation mitigates the need for allogenic blood transfusion, but does not eliminate it. Cell-saver use has been advocated to further reduce the need for transfusion, but recent reports have called its efficacy into question.


METHODS
Data were collected from 188 patients undergoing consecutive instrumented lumbar laminectomy and fusion. One hundred and forty-one of these patients had cell saver used during their procedures, whereas 47 did not. In addition, previously published data from similarly treated patients were used for analysis. Operative blood loss, autologous and allogenic blood transfusions, discharge hematocrit, and patient factors were analyzed.


RESULTS
A significant increase in the number of blood transfusions was found in the cell-saver group. The cell-saver group also had a significantly increased blood loss compared with the non-cell-saver group. Using analysis of covariance, we determined the effect of blood loss on the need for transfusion. The results showed that correcting for blood loss eliminated the significance in the transfusion difference, but cell saver still was not able to decrease the transfusion need. Comparing our current results with our previously published results also demonstrated no benefit of cell saver use.


CONCLUSIONS
Use of cell saver in instrumented lumbar fusion cases was not able to decrease the need for blood transfusion. Cell-saver use was associated with a significantly higher blood loss.
Gause
Paul R
PR
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Siska
Peter A
PA
Westrick
Edward R
ER
Zavatsky
Joseph
J
Irrgang
James J
JJ
Kang
James D
JD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D001804:Blood Transfusion, Autologous; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D013123:Spinal Fusion