Predictive factors of intraoperative cell salvage during pediatric scoliosis surgery. Cell saver during scoliosis surgery in children
| Autor: | Christophe Vidal, Florence Julien-Marsollier, Julie Hilly, Souhayl Dahmani, Daphné Michelet, Thierno Diallo |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Antifibrinolytic Adolescent medicine.drug_class medicine.medical_treatment Blood Loss Surgical Prospective data Hematocrit Critical Care and Intensive Care Medicine Cell saver Body Mass Index 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Humans Medicine Blood Transfusion Orthopedic Procedures Prospective Studies Child 030222 orthopedics medicine.diagnostic_test Operative Blood Salvage business.industry Intraoperative blood salvage General Medicine Confidence interval Scoliosis surgery Surgery Spinal Fusion Treatment Outcome Anesthesiology and Pain Medicine Scoliosis Anesthesia Female Preoperative hemoglobin business 030217 neurology & neurosurgery |
| Zdroj: | Anaesthesia Critical Care & Pain Medicine. 37:141-146 |
| ISSN: | 2352-5568 |
| DOI: | 10.1016/j.accpm.2017.03.003 |
| Popis: | Introduction Blood-saving strategy during spinal surgery in children often includes recombinant erythropoietin (rEPO) and antifibrinolytic therapapy (AFT). The aim of this study was to investigate the efficacy of intraoperative blood salvage in decreasing homologous blood transfusion. Material and methods Using the prospective data from patients operated during a one year period for scoliosis correction, we calculate the predictable hematocrit at day postoperative 1 without the use of blood salvage and compare it to the target hematocrit transfusion according to patient's status. Predictors analyzed were: age, weight, surgical indication, Cobb's angle, ASA status, preoperative hemoglobin, number of level fused, sacral fusion and thoracoplasty. Statistical analyses were performed using a classification tree analysis. Results This study included 147 patients. Blood salvage was estimated avoiding homologous blood transfusion in 17 patients. Predictors of the efficacy of blood salvage were: neuromuscular indications, number of level fused and BMI. Blood salvage was found totally ineffective in: patients with no neuromuscular diseases with either: surgeries interesting 13 levels with a preoperative BMI ≥ 21. In all other cases, blood salvage can decrease homologous transfusion. The model exhibited 97% of accurate for the prediction if the inefficacy of blood salvage. The AUCROC of the model was 0.93 [95% confidence interval 0.9 to 0.99] and the overall validation was 60.1% of explained variability. Conclusion The present study indicates that blood salvage is ineffective under certain circumstances. More studies are mandatory to confirm these results. |
| Databáze: | OpenAIRE |
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