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Carlos V. R. Brown, MD; Kelli H. Foulkrod, MSc; Holli T. Sadler, MD; E. Kalem Richards, LP, CCP; Dennis P. Biggan, LP, CCP; Clea Czysz, RN; Tony Manuel, MD

Arch Surg. 2010;145(7):690-694.

Hypothesis  Intraoperative cell salvage (CS) of shed blood during emergency surgical procedures provides an effective and cost-efficient resuscitation alternative to allogeneic blood transfusion, which is associated with increased morbidity and mortality in trauma patients.

Design  Retrospective matched cohort study.

Setting  Level I trauma center.

Patients  All adult trauma patients who underwent an emergency operation and received CS as part of their intraoperative resuscitation. The CS group was matched to a no-CS group for age, sex, Injury Severity Score, mechanism of injury, and operation performed.

Main Outcome Measures  Amount and cost of allogeneic transfusion of packed red blood cells and plasma.

Results  The 47 patients in the CS group were similar to the 47 in the no-CS group for all matched variables. Patients in the CS group received an average of 819 mL of autologous CS blood. The CS group received fewer intraoperative (2 vs 4 U; P = .002) and total (4 vs 8 U; P < .001) units of allogeneic packed red blood cells. The CS group also received fewer total units of plasma (3 vs 5 U; P = .03). The cost of blood product transfusion (including the total cost of CS) was less in the CS group ($1616 vs $2584 per patient; P = .004).

Conclusion  Intraoperative CS provides an effective and cost-efficient resuscitation strategy as an alternative to allogeneic blood transfusion in trauma patients undergoing emergency operative procedures.

Author Affiliations: Trauma Services, Department of Surgery (Drs Brown and Mss Foulkrod and Czysz), and Departments of Internal Medicine (Dr Sadler) and Anesthesia (Dr Manuel), University Medical Center Brackenridge, and Capital Area Perfusionists (Messrs Richards and Biggan), Austin, Texas.

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