Systematic Review of Intraoperative Blood Salvage in the Surgical Management of Craniosynostosis

Introduction/Background: The purpose of this systematic review is to assess the literature regarding complications associated with intraoperative blood salvage (IOBS) in the setting of surgical management of craniosynostosis. Methods: A systematic review was performed using PubMed/MEDLINE by 2 independent reviewers which included any primary literature investigating the use of IOBS in the surgical management of craniosynostosis. Results: The literature search resulted in 354 initial articles. After removing duplicates and articles not written in English, 330 articles underwent title review, resulting in 25 papers for abstract review. A total of 24 manuscripts were reviewed and 9 were deemed appropriate for inclusion of this systematic review. Two of the nine articles mentioned complications as a secondary objective. Conclusion: There is a paucity of current literature measuring the complications of IOBS in craniosynostosis patients undergoing cranial vault reconstruction.

Impact of Intraoperative Salvaged Blood Autotransfusion During Obstetric Hemorrhage on the Coagulation Function: A Retrospective Cohort Analysis

Objective This study aimed to explore the effect of intraoperative blood salvage (autotransfusion) on coagulation function in the rescue of an obstetric hemorrhage. Methods A total of 65 pregnant women who were diagnosed with placenta previa in our Hospital and gave birth in the hospital were enrolled in the study. All the patients underwent thromboelastography, routine blood tests, and blood coagulation series + D-dimer before and within 30 min of the autologous blood transfusion. The differences in various indicators were evaluated. Results (1) After the autotransfusion, the hemoglobin and neutrophil counts were significantly higher than beforehand, and the platelet count was significantly reduced; the differences were statistically significant (p < .05). (2) There were no significant differences in prothrombin time (PT), fibrinogen, and D-dimer levels before and after the autotransfusion ( p > .05). The activated partial thromboplastin time after autotransfusion was shorter than that beforehand, and the difference was statistically significant ( p < .05). (3) There were no significant differences in the R value, K value, α value, and MA value of the thromboelastogram before and after the autotransfusion ( p > .05). Conclusion After the recovery autotransfusion, the hemoglobin of patients with a massive obstetric hemorrhage increased significantly, while the platelet count decreased, but the coagulation function and thromboelastogram did not change significantly, indicating the autotransfusion did not affect the coagulation function of the obstetric hemorrhage rescue. Thus, it would appear that intraoperative blood salvage can be safely used in the clinical rescue of massive hemorrhaging during cesarean section.

Clinical Efficacy of Intraoperative Cell Saver Autologous Blood Salvage in Emergency Thoracoscopic Surgery for Massive Hemothorax.

Objectives: The objectives of this study were to investigate the efficacy of intraoperative Cell Saver autologous blood salvage in emergency thoracoscopic surgery for massive hemothorax.methods: Nine consecutive cases, including 8 idiopathic hemopneumothoraxes and 1 late-onset traumatic hemothorax, for which emergency surgery was performed at Uji Tokushu-kai Hospital between 2009 and 2016, were retrospectively reviewed. Results: The median total blood loss was 2200 cc (range, 840–4170 cc). Intraoperative Cell Saver autotransfusion with a median volume of 820 cc was performed in the last 7 patients. The first 2 patients who did not receive an autotransfusion required substantially more allogeneic blood transfusion (10 and 14U, respectively), while the other 7 autotransfusion patients required much smaller amounts of allogeneic transfusion (4 U in 3 and 0 U in 4). Four autotransfusion patients who did not undergo preoperative chest tube drainage and/or who had drainage of < 150cc received a greater amount of intraoperative autotransfusion (mean, 1162 ± 414 cc) than the other 3 patients who had a chest tube drainage of ≥ 150 cc (mean, 666.7 ± 150 cc; P = 0.0574). Torn and bleeding arteries were thoracoscopically clipped in 7 patients. One patient with right lung collapse over 2.5 days developed severe acute respiratory distress syndrome intraoperatively, but fully recovered. Conclusions: Utilizing intraoperative autologous blood salvage with the sparing of preoperative chest tube drainage to the maximum possible extent is an efficient strategy to reduce both overall blood loss and allogeneic blood transfusion in emergency thoracoscopic surgery for massive hemothorax.