척추 수술시 자가혈액 수혈기를 이용한 자가수혈의 효과 = Effects of Autologous Transfusion with Cell Saver in Spine Surgery

다국어 초록 (Multilingual Abstract)

Study Design : Spine fusion with fixation procedure is associated with substantial operative blood loss, which frequently necessitates transfusion. The authors evaluated the safety and efficacy of intraoperative autotransfusion using Cell Saver during spinal surgery.
Summary of Literature Review : It has been reported that the contraindications to the use of intraoperative autologous transfusion are malignancy, infection, and gross wound contamination.
Objectives : The purpose of this study was to evaluate the safety and efficacy of intraoperative autotransfusion using Cell Saver during spine surgery.
Material and Methods : We retrospectively reviewed 62 patients who had operation for lumbosacral spinal stenosis and hypotensive anesthesia. Among them, Group Ⅰwhich received autotrans fusion using Cell Savers included 26 patients with fusion of 2 segments, and Group Ⅱ as control group included 13 patients. Group Ⅲ which received autotransfusion using Cell Savers included 17 patients with function of 3 segments, and Group Ⅳ as control group included 6 patients. We analyzed the amount of intraoperative blood salvage using a Cell Saver, the amount of total homologous transfusion amount, intraoperative blood loss, the amount of postoperative drainage amount and perioperative changes of hemoglobin, hematocrit and platelet count.
Results : There was no statistical significance between Cell-Saver group and control group in amount of total homologous transfusion and intraoperative(except in 2 segment of fusion using cell saver: 86.5% increased) & postoperative blood loss(p>0.05). The circulatory balance(amount of intraoperative blood salvage using a Cell Saver plus amount of total homologous transfusion minus amount of total blood loss) was statistical significance between Cell-Saver group and Control group. The Cell-Saver group had positive balance and Control group had negative balance. There were no statistical differance in the evolusion of hemoglobin, hematoocrit and platelet count between Cell-Saver group and Control group(p>0.05). There was no transfusion reaction and thromboembolic disease in all group.
Conclusion : In retrospective study, Cell Savers was safe and immediate availability in orthopedic surgery such as spinal surgery. It was effective methods for storing a sufficient volume of blood for spine surgery without affecting the patient's postoperative hemodynamic ststes, too. It was possible to operation without intraoperative homologous blood transfusion in 2 or 3 segment fusion. We may need further study.