title: Is use of a Continuous Autotransfusion System beneficial in emergency abdominal aortic aneursym (AAA) surgery?
abstract: BACKGROUND
  Allogeneic blood products have become a limited and expensive resource. The Continuous Autotransfusion System (CATS) has been promoted as a method for reducing the need for allogeneic blood transfusion. This study was undertaken to ascertain whether the use of CATS in emergency open AAA surgery has any benefits.
  
  
  METHODS
  This is a retrospective study of all patients undergoing emergency open AAA surgery in our center during a 5-year period (between July 2004 and July 2009). Patients were identified from a prospectively maintained vascular database, and data were obtained from patient records.
  
  
  RESULTS
  CATS was used in 69 emergency open AAA repairs. The median total blood loss was 3,500 mL (range: 751-13,796 mL) but the median volume of packed red blood cells produced by CATS was only 493 mL (~ 2 U). An average of 7 U (range: 0-19 U) of bank blood was still used despite the availability of CATS. The mean hemoglobin 24 hours postoperatively was 10.3 g/dL (6.4-14.1) with a hematocrit of 0.30.
  
  
  CONCLUSIONS
  The use of CATS in emergency AAA surgery does not seem to reduce the use of allogeneic blood transfusion. This may be because of over transfusion, as reflected by relatively high postoperative hemoglobin levels.
authors.affiliation: Department of Vascular and Endovascular Surgery, Leicester Royal Infirmary, Leicester, UK. clrnbrown@doctors.org.uk
authors.forename: C N
authors.initials: CN
authors.lastname: Brown
authors.forename: C
authors.initials: C
authors.lastname: Hakim
authors.forename: R D
authors.initials: RD
authors.lastname: Sayers
authors.forename: N J M
authors.initials: NJ
authors.lastname: London
authors.forename: A
authors.initials: A
authors.lastname: Nasim
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000097:blood / Q000601:surgery*; D001019:Aortic Rupture / Q000097:blood / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D016913:Blood Component Transfusion; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000295:instrumentation*; D004739:England; D004867:Equipment Design; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D057725:Operative Blood Salvage / Q000009:adverse effects / Q000295:instrumentation*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects
chemical_list: D015415:Biomarkers; D006454:Hemoglobins