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Métodos Terapêuticos e Terapias MTCI
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Arch Surg ; 145(7): 690-4, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20644133

RESUMO

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.


Assuntos
Transfusão de Sangue Autóloga/economia , Transfusão de Sangue Autóloga/estatística & dados numéricos , Tratamento de Emergência/economia , Tratamento de Emergência/métodos , Custos de Cuidados de Saúde , Procedimentos Cirúrgicos Operatórios/economia , Procedimentos Cirúrgicos Operatórios/métodos , Adulto , Idoso , Transfusão de Componentes Sanguíneos/economia , Transfusão de Componentes Sanguíneos/estatística & dados numéricos , Perda Sanguínea Cirúrgica , Estudos de Casos e Controles , Estudos de Coortes , Análise Custo-Benefício , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Texas , Transplante Homólogo , Centros de Traumatologia , Resultado do Tratamento
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