Intraoperative blood salvage reduces the requirements for allogenic blood transfusion and transfusion related inflammatory response in abdominal aortic aneurysm surgery: Blood transfusion and abdominal aortic aneurysm surgery

Introduction. Intraoperative blood salvage (IBS) is a procedure involving recovering blood looses during surgery and reinfusing it into the patient with a purpose to reduce the perioperative morbidity and mortality associated with complications after administration of allogenic transfusion (AT). The aim of this study was to investigate whether the IBS reduces the need for allogenic transfusion requirements and for non-invasive ventilation (NIV) and/or oxygen supplementation and whether it was associated with decreased levels of inflammatory markers following abdominal aortic aneurysm (AAA) surgery. Methods. Throughout the period from February to October 2010, 51 patients underwent both elective and emergency AAA surgery. During the study period, IBS using 'Haemonetics cell saver 5+' was applied in 24 (46.2%) patients (CS group), while it wasn't used in 27 (51.9%) cases (NCS group). Values of certain inflammatory biomarkers included: white blood cell count (WBCC), C-reactive protein (CRP), procalcitonin (PCT) and fibrinogen were monitored during the first 48 hours postoperatively. Secondary outcome measures icluded: the need for allogenic transfusion and for non-invasive ventilation (NIV) and/or oxygen supplementation. Results. The requirements for intra and postoperative alogenic red blood cells transfusions was significantly higher in patients from NCS group compared to patients in CS group (3.63 vs. 0.58 units per patient; p< 0.001). Non-invasive respiratory support was more frequently used in patient from NCS group (4/27) compared to those in CS (1/24) group but difference was not statistically significant (p=0.17). The postoperatively average WBCC was significantly higher among patients in NCS group compared to those from CS group (12.89 x 109 vs. 10.44 x109; p=0.014). Also CRP plasma levels postoperatively were significantly higher in NCS group compared to CS group (67.18 mg.L-1 vs. 47.54 mg.L-1; p=0.015). Conclusion(s). The usage of intraoperative blood savage reduces postoperative requirements for allogenic blood transfusion and need for non-invasive respiratory support following major vascular surgery and might be associated with decreased levels of certain inflammatory markers.