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Trauma

BLOOD MANAGEMENT IN SCOLIOSIS SURGERY. COMPARISON OF PREOPERATIVE AUTOLOGOUS BLOOD DONATION WITH INTRA-OPERATIVE BLOOD SALVAGE (BLOOD SAVER) SYSTEMS

European Federation of National Associations of Orthopaedics and Traumatology (EFORT) - 12th Congress



Abstract

AIM

Retrospective study comparing the effectiveness of preoperative autologous blood donation versus intra-operative blood saver systems in minimizing the need for allogeneic blood transfusion in scoliosis surgery.

MATERIALS – METHODS

Between 2003–2009, 37 of the patients (4–33, mean age 20y) who underwent scoliosis surgery, were divided in two groups. The first group (20 patients, mean age 18.7y) underwent autologous blood predonation, prerequisities were body weight over 50 kgr and Hgb above 11 mg/dl. The second group (17 patients, mean age 21.5y) consisted of patients who did not meet the above prerequisities and blood saver was used intra-operatively. Duration of surgery and perioperative Haemoglobulin (Hgb) levels were recorded in both groups.

RESULTS

In group A an average of 4 autologous blood units per patient were predonated (3–5 units/patient) and the mean transfusion rate was 3.4 autologous blood units/patient. Only one patient was transfused with one allogeneic blood unit while of the 81 predeposited autologous blood units 15 were wasted (18.5%). In Group B intra-operative autotransfusion systems salvaged 302.9 ml/patient (150–500 ml/patient) while the mean transfusion rate was 2.1 allogeneic blood units/patient.

CONCLUSIONS

The use of intra-operative autotransfusion systems seems to reduce the need for allogeneic blood transfusion when compared with preoperative autologous blood donation. However, the lower preoperative Hgb in Group B have to be taken under consideration. Further studies need to prove the effectiveness of these methods so that perioperative blood management minimizes the need for allogeneic blood transfusion in scoliosis surgery.