An analysis of transfusion practice and the role of intraoperative red blood cell salvage during cesarean delivery

Jill Fong, Edith D. Gurewitsch, Hey Joo Kang, Lisa Kump, Patricia Fogarty Mack

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

BACKGROUND: We sought to determine to what extent intraoperative salvaged red blood cells (RBC) might theoretically reduce exposure to appropriately transfused allogenic erythrocytes in Cesarean delivery patients. METHODS: Medical records of Cesarean delivery patients requiring blood transfusions from January 1, 1992 to June 30, 1996 and June 1, 1998 to June 30, 2003 were reviewed. For each patient, we calculated the number of allogenic RBC units that could have theoretically been avoided had intraoperative autotransfusion been performed, based upon estimated blood loss, preoperative hematocrit, and the amount of retrieved blood needed to yield a single RBC unit. RBC transfusion appropriateness was determined using the recommended guideline of transfusing RBCs if the hemoglobin is <7 gm/dL in a patient with continuing bleeding. RESULTS: A small percentage of Cesarean delivery patients (1.8%) received blood product transfusions. Of 207 patients receiving blood transfusions, salvaged erythrocytes could have theoretically decreased exposure to allogenic RBCs in 115 (55.6%) patients. Only 75.7% of these 115 patients were appropriately transfused with erythrocytes. CONCLUSION: Theoretically, based on best, average, and worst RBC salvage recovery calculations, 25.1%, 21.2%, or 14.5% of the appropriately transfused patients, respectively, could have completely avoided allogenic RBC transfusion.

Original languageEnglish (US)
Pages (from-to)666-672
Number of pages7
JournalAnesthesia and analgesia
Volume104
Issue number3
DOIs
StatePublished - Mar 1 2007
Externally publishedYes

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ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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