Autologous blood transfusion during emergency trauma operations.
OBJECTIVE
Intraoperative cell salvage (CS) of shed blood during emergency surgical procedures provides an effective and cost-efficient resuscitation alternative to allogeneic blood transfusion, which is associated with increased morbidity and mortality in trauma patients.


METHODS
Retrospective matched cohort study.


METHODS
Level I trauma center.


METHODS
All adult trauma patients who underwent an emergency operation and received CS as part of their intraoperative resuscitation. The CS group was matched to a no-CS group for age, sex, Injury Severity Score, mechanism of injury, and operation performed.


METHODS
Amount and cost of allogeneic transfusion of packed red blood cells and plasma.


RESULTS
The 47 patients in the CS group were similar to the 47 in the no-CS group for all matched variables. Patients in the CS group received an average of 819 mL of autologous CS blood. The CS group received fewer intraoperative (2 vs 4 U; P = .002) and total (4 vs 8 U; P < .001) units of allogeneic packed red blood cells. The CS group also received fewer total units of plasma (3 vs 5 U; P = .03). The cost of blood product transfusion (including the total cost of CS) was less in the CS group ($1616 vs $2584 per patient; P = .004).


CONCLUSIONS
Intraoperative CS provides an effective and cost-efficient resuscitation strategy as an alternative to allogeneic blood transfusion in trauma patients undergoing emergency operative procedures.
Brown
Carlos V R
CV
Trauma Services, University Medical Center Brackenridge, 601 E 15th St., Austin, TX 78701, USA. CVRBrown@seton.org
Foulkrod
Kelli H
KH
Sadler
Holli T
HT
Richards
E Kalem
EK
Biggan
Dennis P
DP
Czysz
Clea
C
Manuel
Tony
T
D000328:Adult; D000368:Aged; D016913:Blood Component Transfusion / Q000191:economics / Q000706:statistics & numerical data; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000191:economics* / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D004638:Emergency Treatment / Q000191:economics* / Q000379:methods*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000191:economics* / Q000379:methods*; D013781:Texas; D014184:Transplantation, Homologous; D014193:Trauma Centers; D016896:Treatment Outcome