Optimising the use of cell salvage in revision hip arthroplasty

J Perioper Pract. 2023 Jul-Aug;33(7-8):239-247. doi: 10.1177/17504589221099832. Epub 2022 Jun 2.

Abstract

Background: Intraoperative cell salvage is an established method to reduce the requirement for and the volume of allogenic blood transfusion but adds to the financial cost of performing surgery.

Aims: The primary aim of this study was to determine which patients and what type of revision hip surgery benefit most from intraoperative cell salvage.

Methods: This observational study included patients who underwent revision hip surgery performed by the senior author at a single orthopaedic unit. The cohort was divided into single and two-component revision groups; then, the transfusion requirement combined with analysis of patient factors was used to create a decision-making protocol.

Findings: The two-component group had a significantly higher number of cases using cell salvage and a higher total transfusion volume. Patients who required postoperative allogenic blood transfusions had a higher mean age, were less likely to have received tranexamic acid and had a lower preoperative haemoglobin level.

Conclusion: Based on these results, a decision-making protocol was developed for when to use cell salvage in revision hip surgery.

Keywords: Allogenic blood transfusion; Cell salvage; Intraoperative blood loss; Revision hip surgery.

Publication types

  • Observational Study

MeSH terms

  • Arthroplasty, Replacement, Hip*
  • Blood Transfusion
  • Blood Transfusion, Autologous / methods
  • Humans
  • Retrospective Studies
  • Tranexamic Acid*

Substances

  • Tranexamic Acid