Revista Cubana de Anestesiología y Reanimación (Sep 2017)
Effect of homologous transfusions and the autologous blood recovery system in highly complex surgical patients
Abstract
Introduction: Autologous transfusion has three modalities: autologous transfusion with predeposit, preoperative hemodilution (normovolemic or hypervolemic), and the system for autologous blood recovery (cell saver), whether intraoperative or postoperative.Objective: To show the effectiveness of the use of the autologous blood recovery system in highly complex surgical patients at Alcívar Hospital.Method: Nonexperimental, retrospective study, of indirect observation and with correlational analysis. The sample consisted of 112 patients who underwent surgery for cardiovascular, orthopedic and traumatological conditions, chosen based on inclusion and exclusion criteria. The cell saver system was used in 56 patients and 56 patients used homologous blood transfusions.Results: The cell saver system was beneficial in 93 % of patients; morbidity and mortality decreased, mainly in patients operated for any cardiovascular condition, while the cost-benefit ratio increased, due to the fact prioritization of economic resources. In traumatology and orthopedics, it was not so beneficial, since the amount of blood recovered fluctuated between 300 and 500 mL in conventional interventions, which motivated the use of blood products and increased the cost. In tumor resections and instrumentation of different spine segments, up to 800 mL of blood were recovered, which was significant. The complication rate was lower in patients who used the cell saver system (7 %), compared to patients who used homologous blood products (32 %). A shorter hospital stay was observed in the cell saver group (1-20 days), compared to those who used homologous blood products (over 10 days, while in 5 cases it was over 21 days).Conclusions: The use of the autologous blood recovery system is an effective procedure to infuse blood products with greater safety.
