PMID- 12096253
OWN - NLM
STAT- MEDLINE
DCOM- 20020731
LR  - 20190822
IS  - 0741-5214 (Print)
IS  - 0741-5214 (Linking)
VI  - 36
IP  - 1
DP  - 2002 Jul
TI  - Acute normovolemic hemodilution and intraoperative cell salvage in aortic 
      surgery.
PG  - 31-4
AB  - OBJECTIVE: The objective of this study was to report current transfusion 
      requirements and outcomes in patients undergoing elective aortic surgery with 
      autologous transfusion. METHODS: This was a retrospective review of transfusion 
      practice in infrarenal aortic surgery in a tertiary vascular unit with a 
      longstanding interest in autologous transfusion. One hundred and ten consecutive 
      patients underwent infrarenal aortic surgery with a combination of acute 
      normovolemic hemodilution (ANH) and intraoperative cell salvage (ICS). All 
      patients underwent hemodilution to a target hemoglobin concentration of 11 g/dL 
      and underwent ICS with a centrifugal device. RESULTS: Median blood loss was 1140 
      mL (interquartile range [IQR], 683 to 1609 mL) in 78 aneurysm repairs and 775 mL 
      (IQR, 400 to 1225 mL) in 32 aortobifemoral bypasses for occlusive disease (P 
      =.02), resulting in a median salvaged red cell volume of 403 mL (IQR, 256 to 563 
      mL) for aneurysm repairs and 250 mL (IQR, 200 to 290 mL) in bypass surgery (P 
      =.001). Thirty-six patients (33%) needed transfusion of stored blood, for a total 
      of 115 units, with just four patients needing more than five units. The mortality 
      rate was 8% (9/110). With multivariate analysis, low hemoglobin level (P =.006) 
      and low platelet count (P =.023) were associated with stored blood transfusion. 
      CONCLUSION: Blood loss is too small to justify ICS in surgery for occlusive 
      disease; ANH alone may be a suitable strategy. With appropriate experience, the 
      combination of ANH and ICS may render crossmatching unnecessary, even in aortic 
      aneurysm surgery.
FAU - Torella, Francesco
AU  - Torella F
AD  - Academic Surgery Unit, Education and Research Centre, Wythenshawe Hospital, 
      Manchester, United Kingdom.
FAU - Haynes, Sarah L
AU  - Haynes SL
FAU - Kirwan, Cliona C
AU  - Kirwan CC
FAU - Bhatt, Anand N
AU  - Bhatt AN
FAU - McCollum, Charles N
AU  - McCollum CN
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Vasc Surg
JT  - Journal of vascular surgery
JID - 8407742
RN  - 0 (Hemoglobins)
SB  - IM
MH  - Aged
MH  - Aorta, Abdominal/*surgery
MH  - Aortic Aneurysm, Abdominal/physiopathology/therapy
MH  - Aortic Aneurysm, Thoracic/physiopathology/therapy
MH  - Blood Loss, Surgical
MH  - Blood Transfusion, Autologous
MH  - Blood Volume/*physiology
MH  - *Elective Surgical Procedures
MH  - Female
MH  - *Hemodilution
MH  - Hemoglobins/analysis
MH  - Humans
MH  - *Intraoperative Care
MH  - Male
MH  - Middle Aged
MH  - Platelet Count
MH  - *Salvage Therapy
MH  - Treatment Outcome
MH  - United Kingdom
EDAT- 2002/07/04 10:00
MHDA- 2002/08/01 10:01
CRDT- 2002/07/04 10:00
PHST- 2002/07/04 10:00 [pubmed]
PHST- 2002/08/01 10:01 [medline]
PHST- 2002/07/04 10:00 [entrez]
AID - S0741-5214(02)00004-6 [pii]
AID - 10.1067/mva.2002.124363 [doi]
PST - ppublish
SO  - J Vasc Surg. 2002 Jul;36(1):31-4. doi: 10.1067/mva.2002.124363.