JAMA logoOne of the leading causes of death amongst people aged 1 to 44 years is injury from trauma, with extreme blood loss being a cause in almost half of the cases. Such deaths especially occur in the operating room or within 24 hours after the injury. Scientists allege that blood can be transfused with a trauma patient’s own blood instead of an individual as a resuscitation method during surgery. Patients in a state of shock due to hemorrhaging often require a blood transfusion with packed red blood cells and plasma.

While undertaking the study, the authors examined 47 adult trauma patients undergoing an emergency operation in 2006 or 2007. All the study participants were provided with an intraoperative cell salvage, a process in which shed blood is accumulated and processed so the red blood cells can be transfused back into the patient. In the course of the investigations, the scientists compared two patients with each other. While one belonged to the cell salvage group, the other featured in the comparison group.

The scientists explain, “Any transfusion with allogeneic [from another individual] blood products is associated with a variety of complications, including transfusion reaction, transmission of infectious diseases and sensitization to antigens. Furthermore, transfusion of allogeneic blood products in trauma patients has been independently associated with increased morbidity and mortality, particularly when transfusing older, stored blood products.”

Carlos V. R. Brown, M.D., of University Medical Center Brackenridge, Austin, Texas, and colleagues mentioned that both the patients had the same sex, age, mechanism, severity of injury and went through the same operation, but without cell salvage. Patients belonging to the cell salvage group reported an average intra-operative blood loss of 1,795 milliliters. These patients also acquired an average return of 819 milliliters of their own blood.

The experts added, “In conclusion, the present matched cohort study adds to the existing literature regarding the beneficial effects of intraoperative cell salvage and autologous transfusion in trauma patients undergoing an emergency surgical intervention. Additional studies are needed to definitively confirm the safety of transfusing contaminated blood, to pre-operatively identify patients who would most benefit from autologous transfusion and to optimize cost-effectiveness. In the meantime, centers with access to a cell salvage program should routinely use autologous transfusion as part of their intraoperative resuscitation. More important, centers not currently using intraoperative cell salvage and autotransfusion should identify and overcome barriers to implementing this life-saving technique.”

The cell salvage group was provided with lesser intraoperative and total units of allogeneic packed red blood cells as compared to the other group. While two units were given to the cell salvage group during surgery, the comparison group received four units. The total units of plasma were three units for cell salvage group and five units for patients from the comparison group. The total cost of blood product transfusion along with the total cost of cell salvage for patients from the cell salvage group was $1,616 and for the comparison group it was $2,584.

Patients belonging to both the groups were in the intensive care unit for around eight days. Cell salvage group patients were hospitalized for 18 days and comparison group patients remained in the hospital for 20 days. No variation in death rates was monitored in patients from both the groups. The death rate in the cell salvage group was 13 percent comprising six patients and 21 percent representing 10 patients death rate was reported in the comparison group.

The study is published in the July issue of Archives of Surgery, one of the JAMA/Archives journals.