Washed cell salvage in surgical patients : a review and meta-analysis of prospective randomized trials under PRISMA
- Background: Cell salvage is commonly used as part of a blood conservation strategy. However concerns among clinicians exist about the efficacy of transfusion of washed cell salvage. Methods: We performed a meta-analysis of randomized controlled trials in which patients, scheduled for all types of surgery, were randomized to washed cell salvage or to a control group with no cell salvage. Data were independently extracted, risk ratio (RR), and weighted mean differences (WMD) with 95% confidence intervals (CIs) were calculated. Data were pooled using a random effects model. The primary endpoint was the number of patients exposed to allogeneic red blood cell (RBC) transfusion. Results: Out of 1140 search results, a total of 47 trials were included. Overall, the use of washed cell salvage reduced the rate of exposure to allogeneic RBC transfusion by a relative 39% (RR = 0.61; 95% CI 0.57 to 0.65; P < 0.001), resulting in an average saving of 0.20 units of allogeneic RBC per patient (weighted mean differences [WMD] = -0.20; 95% CI -0.22 to -0.18; P < 0.001), reduced risk of infection by 28% (RR = 0.72; 95% CI 0.54 to 0.97; P = 0.03), reduced length of hospital stay by 2.31 days (WMD = -2.31; 95% CI -2.50 to -2.11; P < 0.001), but did not significantly affect risk of mortality (RR = 0.92; 95% CI 0.63 to 1.34; P = 0.66). No statistical difference could be observed in the number of patients exposed to re-operation, plasma, platelets, or rate of myocardial infarction and stroke. Conclusions: Washed cell salvage is efficacious in reducing the need for allogeneic RBC transfusion and risk of infection in surgery.
Verfasserangaben: | Patrick MeybohmORCiDGND, Suma ChoorapoikayilGND, Anke Wessels, Eva HerrmannORCiDGND, Kai ZacharowskiORCiDGND, Donat Rudolf SpahnORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-440212 |
DOI: | https://doi.org/10.1097/MD.0000000000004490 |
ISSN: | 1536-5964 |
ISSN: | 0025-7974 |
Pubmed-Id: | https://pubmed.ncbi.nlm.nih.gov/27495095 |
Titel des übergeordneten Werkes (Englisch): | Medicine |
Verlag: | Lippincott Williams & Wilkins |
Verlagsort: | Baltimore, Md. |
Sonstige beteiligte Person(en): | Kazuo Hanaoka |
Dokumentart: | Wissenschaftlicher Artikel |
Sprache: | Englisch |
Datum der Veröffentlichung (online): | 11.05.2017 |
Jahr der Erstveröffentlichung: | 2016 |
Veröffentlichende Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Datum der Freischaltung: | 11.05.2017 |
Freies Schlagwort / Tag: | Cell salvage; Patient blood management; Transfusion |
Jahrgang: | 95 |
Ausgabe / Heft: | 31, Art. e4490 |
Seitenzahl: | 9 |
Erste Seite: | 1 |
Letzte Seite: | 9 |
Bemerkung: | Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CC-BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. |
HeBIS-PPN: | 425324478 |
Institute: | Medizin / Medizin |
DDC-Klassifikation: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Lizenz (Deutsch): | ![]() |