Does use of intraoperative cell-salvage delay recovery in patients undergoing elective abdominal aortic surgery?

Abstract

A best evidence topic in vascular surgery was written according to a structured protocol. The question addressed was whether the use ofintraoperative cell-salvage (ICS) leads to negative outcomes in patients undergoing elective abdominal aortic surgery? Altogether 305papers were found using the reported search, of which 10 were judged to represent the best evidence to answer the clinical question. Theauthors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers weretabulated. None of the 10 papers included in the analysis demonstrated that ICS use led to significantly higher incidence of cardiac orseptic postoperative complications. Similarly, length of intensive treatment unit (ITU) or hospital stay and mortality in elective abdominalaortic surgery were not adversely affected. Indeed two trials actually show a significantly shorter hospital stay after ICS use, one a shorterITU stay and another suggests lower rates of chest sepsis. Based on these papers, we concluded that the use of ICS does not cause increasedmorbidity or mortality when compared to standard practise of transfusion of allogenic blood, and may actually improve some clinicaloutcomes. As abdominal aortic surgery inevitably causes significant intraoperative blood loss, in the range of 661-3755 ml as described inthe papers detailed in this review, ICS is a useful and safe strategy to minimise use of allogenic blood. © 2011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.