Cell salvage for minimising perioperative allogeneic blood transfusion
Concerns regarding the safety of transfused blood, have prompted reconsideration of the use of allogeneic (blood from an unrelated donor) red blood cell (RBC) transfusion, and a range of techniques to minimise transfusion requirements. To examine the evidence for the efficacy of cell salvage in redu...
Saved in:
Published in | Cochrane database of systematic reviews no. 4; p. CD001888 |
---|---|
Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
England
18.10.2006
|
Subjects | |
Online Access | Get more information |
Cover
Loading…
Abstract | Concerns regarding the safety of transfused blood, have prompted reconsideration of the use of allogeneic (blood from an unrelated donor) red blood cell (RBC) transfusion, and a range of techniques to minimise transfusion requirements.
To examine the evidence for the efficacy of cell salvage in reducing allogeneic blood transfusion and the evidence for any effect on clinical outcomes.
We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Current Contents and the websites of international health technology assessment agencies. The reference lists in identified trials and review articles were also searched, and study authors were contacted to identify additional studies. The searches were updated in January 2004.
Controlled parallel group trials in which adult patients, scheduled for non-urgent surgery, were randomised to cell salvage, or to a control group, who did not receive the intervention.
Two authors independently screened search results, extracted data and assessed methodological quality. The main outcomes measures were the number of patients exposed to allogeneic red cell transfusion, and the amount of blood transfused. Other outcomes measured were re-operation for bleeding, blood loss, post-operative complications (thrombosis, infection, non-fatal myocardial infarction, renal failure), mortality, and length of hospital stay (LOS).
Overall, the use of cell salvage reduced the rate of exposure to allogeneic RBC transfusion by a relative 39% (relative risk [RR] = 0.61: 95% confidence interval [CI] 0.52 to 0.71). The absolute reduction in risk (ARR) of receiving an allogeneic RBC transfusion was 23% (95% CI 16% to 30%). In orthopaedic procedures the RR of exposure to RBC transfusion was 0.42 (95% CI 0.32 to 0.54) compared to 0.77 (95% CI 0.68 to 0.87) for cardiac procedures. The use of cell salvage resulted in an average saving of 0.67 units of allogeneic RBC per patient (weighted mean difference was -0.64; 95% CI -0.89 to -0.45). Cell salvage did not appear to impact adversely on clinical outcomes.
The results suggest cell salvage is efficacious in reducing the need for allogeneic red cell transfusion in adult elective surgery. However, the methodological quality of trials was poor. As the trials were unblinded and lacked adequate concealment of treatment allocation, transfusion practices may have been influenced by knowledge of the patients' treatment status biasing the results in favour of cell salvage. |
---|---|
AbstractList | Concerns regarding the safety of transfused blood, have prompted reconsideration of the use of allogeneic (blood from an unrelated donor) red blood cell (RBC) transfusion, and a range of techniques to minimise transfusion requirements.
To examine the evidence for the efficacy of cell salvage in reducing allogeneic blood transfusion and the evidence for any effect on clinical outcomes.
We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Current Contents and the websites of international health technology assessment agencies. The reference lists in identified trials and review articles were also searched, and study authors were contacted to identify additional studies. The searches were updated in January 2004.
Controlled parallel group trials in which adult patients, scheduled for non-urgent surgery, were randomised to cell salvage, or to a control group, who did not receive the intervention.
Two authors independently screened search results, extracted data and assessed methodological quality. The main outcomes measures were the number of patients exposed to allogeneic red cell transfusion, and the amount of blood transfused. Other outcomes measured were re-operation for bleeding, blood loss, post-operative complications (thrombosis, infection, non-fatal myocardial infarction, renal failure), mortality, and length of hospital stay (LOS).
Overall, the use of cell salvage reduced the rate of exposure to allogeneic RBC transfusion by a relative 39% (relative risk [RR] = 0.61: 95% confidence interval [CI] 0.52 to 0.71). The absolute reduction in risk (ARR) of receiving an allogeneic RBC transfusion was 23% (95% CI 16% to 30%). In orthopaedic procedures the RR of exposure to RBC transfusion was 0.42 (95% CI 0.32 to 0.54) compared to 0.77 (95% CI 0.68 to 0.87) for cardiac procedures. The use of cell salvage resulted in an average saving of 0.67 units of allogeneic RBC per patient (weighted mean difference was -0.64; 95% CI -0.89 to -0.45). Cell salvage did not appear to impact adversely on clinical outcomes.
The results suggest cell salvage is efficacious in reducing the need for allogeneic red cell transfusion in adult elective surgery. However, the methodological quality of trials was poor. As the trials were unblinded and lacked adequate concealment of treatment allocation, transfusion practices may have been influenced by knowledge of the patients' treatment status biasing the results in favour of cell salvage. |
Author | Fergusson, D A O'connell, D L Henry, D A Carless, P A Moxey, A J Brown, T |
Author_xml | – sequence: 1 givenname: P A surname: Carless fullname: Carless, P A email: Paul.Carless@newcastle.edu.au organization: Faculty of Health, The University of Newcastle, Discipline of Clinical Pharmacology, Level 5, Clinical Sciences Building, Newcastle Mater Hospital, Edith Street, Waratah, Newcastle, New South Wales, Australia. Paul.Carless@newcastle.edu.au – sequence: 2 givenname: D A surname: Henry fullname: Henry, D A – sequence: 3 givenname: A J surname: Moxey fullname: Moxey, A J – sequence: 4 givenname: D L surname: O'connell fullname: O'connell, D L – sequence: 5 givenname: T surname: Brown fullname: Brown, T – sequence: 6 givenname: D A surname: Fergusson fullname: Fergusson, D A |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/17054147$$D View this record in MEDLINE/PubMed |
BookMark | eNo1j8tKxDAYhYMozkVfYcgLtObaJkupzigMuFFwN_xt_5ZImpSmM-DbW1A35ywOfIdvQ65DDEjIjrOcMyYeuCo0N9rk1RNj3BiTj-daXJH1MthMWfm5IpuUvhiTlnNzS1a8ZFpxVa7JvkLvaQJ_gR5pFyc6uOAGl1zo6YiTi0vA7C5IwfvYY0DX0NrH2NJ5gpC6c3Ix3JGbDnzC-7_eko_983v1kh3fDq_V4zFrZCHnTJrWgiyFKRpVL_9SG9uWBWimsYGCoaoRQHW6BSGYQYtSIXLeKamFZUpsye6XuxgO2J7GyQ0wfZ_-hcQPyUZPmQ |
CitedBy_id | crossref_primary_10_1016_j_ijoa_2007_08_001 crossref_primary_10_1177_1098612X18785742 crossref_primary_10_2106_JBJS_17_00237 crossref_primary_10_1111_j_1365_3148_2009_00914_x crossref_primary_10_1016_j_oto_2019_100716 crossref_primary_10_3390_surgeries3010007 crossref_primary_10_1590_acb386423 crossref_primary_10_4254_wjh_v5_i1_1 crossref_primary_10_12968_hmed_2009_70_1_37691 crossref_primary_10_1136_bmjopen_2016_012947 crossref_primary_10_4240_wjgs_v8_i2_161 crossref_primary_10_15406_mojor_2016_04_00150 crossref_primary_10_1007_s00068_016_0655_8 crossref_primary_10_1111_j_1365_2044_2010_06301_x crossref_primary_10_1016_j_ejvs_2010_09_011 crossref_primary_10_1055_a_1864_0609 crossref_primary_10_1016_j_urolonc_2022_11_010 crossref_primary_10_1016_S0140_6736_13_60808_9 crossref_primary_10_1007_s00101_018_0529_z crossref_primary_10_7243_2052_4358_5_1 crossref_primary_10_1016_S0214_9168_16_30026_2 crossref_primary_10_1080_22201173_2008_10872520 crossref_primary_10_1111_j_1537_2995_2012_03835_x crossref_primary_10_1007_s00402_007_0565_7 crossref_primary_10_1186_s13019_023_02246_w crossref_primary_10_1159_000361062 crossref_primary_10_1016_j_mpsur_2015_11_007 crossref_primary_10_15388_LietChirur_2021_20_48 crossref_primary_10_1111_j_1365_2044_2011_06862_x crossref_primary_10_1002_rth2_12395 crossref_primary_10_1016_j_tracli_2008_01_006 crossref_primary_10_1016_j_bja_2023_12_014 crossref_primary_10_1093_bja_aep001 crossref_primary_10_1007_s40140_019_00343_y crossref_primary_10_1016_j_mpsur_2012_12_006 crossref_primary_10_1016_j_bpa_2015_11_007 crossref_primary_10_1016_j_periop_2010_08_006 crossref_primary_10_1016_j_athoracsur_2010_02_003 crossref_primary_10_12968_hmed_2009_70_1_37689 crossref_primary_10_1111_j_1471_0528_2009_02129_x crossref_primary_10_1302_0301_620X_90B9_21115 |
ContentType | Journal Article |
DBID | CGR CUY CVF ECM EIF NPM |
DOI | 10.1002/14651858.CD001888.pub2 |
DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) |
DatabaseTitleList | MEDLINE |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | no_fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1469-493X |
ExternalDocumentID | 17054147 |
Genre | Meta-Analysis Review Systematic Review Journal Article |
GrantInformation_xml | – fundername: Department of Health grantid: 02/36/01 |
GroupedDBID | --- 53G 5GY 7PX 9HA ABJNI ACGFO ACGFS AENEX ALMA_UNASSIGNED_HOLDINGS ALUQN AYR CGR CUY CVF D7G ECM EIF HYE NPM OEC OK1 P2P RWY WOW ZYTZH |
ID | FETCH-LOGICAL-c363t-38d9a37286c4b1473589d76a505eca60e4beaa4f5da2208e9e34ee11f43529042 |
IngestDate | Sat Sep 28 08:26:12 EDT 2024 |
IsDoiOpenAccess | false |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 4 |
Language | English |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c363t-38d9a37286c4b1473589d76a505eca60e4beaa4f5da2208e9e34ee11f43529042 |
OpenAccessLink | https://europepmc.org/articles/pmc4163967?pdf=render |
PMID | 17054147 |
ParticipantIDs | pubmed_primary_17054147 |
PublicationCentury | 2000 |
PublicationDate | 2006-Oct-18 |
PublicationDateYYYYMMDD | 2006-10-18 |
PublicationDate_xml | – month: 10 year: 2006 text: 2006-Oct-18 day: 18 |
PublicationDecade | 2000 |
PublicationPlace | England |
PublicationPlace_xml | – name: England |
PublicationTitle | Cochrane database of systematic reviews |
PublicationTitleAlternate | Cochrane Database Syst Rev |
PublicationYear | 2006 |
References | 14583940 - Cochrane Database Syst Rev. 2003;(4):CD001888 20238316 - Cochrane Database Syst Rev. 2010;(3):CD001888 |
References_xml | |
SSID | ssj0039118 |
Score | 2.347901 |
SecondaryResourceType | review_article |
Snippet | Concerns regarding the safety of transfused blood, have prompted reconsideration of the use of allogeneic (blood from an unrelated donor) red blood cell (RBC)... |
SourceID | pubmed |
SourceType | Index Database |
StartPage | CD001888 |
SubjectTerms | Blood Specimen Collection - methods Blood Transfusion, Autologous Elective Surgical Procedures Erythrocyte Transfusion Humans Randomized Controlled Trials as Topic |
Title | Cell salvage for minimising perioperative allogeneic blood transfusion |
URI | https://www.ncbi.nlm.nih.gov/pubmed/17054147 |
hasFullText | |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3dS8MwEA9-gPgifn9LHnyTatOkXfoomyLC9qTgm6TJFQXdBk4R_3rvmnaZ8wMVSinJFkru18vlcvc7xg5LUViiBUPwxjJSVosIV7k0AuVKvGzsJCUnd3vZxbW6vElvQuhQlV0yKo7t25d5Jf-RKrahXClL9g-SHQ-KDfiM8sU7Shjvv5JxmxxvT-bhhQJvKF6QiEJQcFWGOb7AYAg1sTcdr-MwcG99qDqVhkCD9fmpEUtDVjCwd9gDRxQ5SiscGZPTbM_BDm9XZ_We6z94RceJD53Q1h28euf4aTiIokAbGwJtOnUGRPBBCH8gTEuI15u4y45UXpX2bSCjJvRiu0PV_3wBv09K25PACqrKrlN93PyWAJlM_gEnf_hYiZI4gJTwVJ0_906RaTdds2y2pUkh9si54xduiXpfN0nkcXLy9QsRy2w9yNROpLJIrpbZUr2V4KceFytsBvqrbKFbB0ussXOCB6_hwREePMCDf4AHD_DgFTz4BDzW2fX52VX7IqrLZkRWZnIUSe1yI1uJzqwqBJWW1rlrZQZtXbAmi0EVYIwqU2eSJNaQg1QAQpRoOSc5KvENNtcf9GGLcUjzIhfGFa24VOC0Bimcs8LYQjlVmm226Wfgdui5UW6budn5tmeXLQYI7bH5Ej9G2EfLblQcVPJ4By-sTKM |
link.rule.ids | 786 |
linkProvider | National Library of Medicine |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Cell+salvage+for+minimising+perioperative+allogeneic+blood+transfusion&rft.jtitle=Cochrane+database+of+systematic+reviews&rft.au=Carless%2C+P+A&rft.au=Henry%2C+D+A&rft.au=Moxey%2C+A+J&rft.au=O%27connell%2C+D+L&rft.date=2006-10-18&rft.eissn=1469-493X&rft.issue=4&rft.spage=CD001888&rft_id=info:doi/10.1002%2F14651858.CD001888.pub2&rft_id=info%3Apmid%2F17054147&rft_id=info%3Apmid%2F17054147&rft.externalDocID=17054147 |