Partly intraoperative cell salvage in pediatric craniocerebral trauma: effects on coagulation function, allogeneic blood requirements, and clinical outcomes — a propensity score-matched retrospective cohort study - Report - MDSpire
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Partly intraoperative cell salvage in pediatric craniocerebral trauma: effects on coagulation function, allogeneic blood requirements, and clinical outcomes — a propensity score-matched retrospective cohort study
Effects of Partial Intraoperative Cell Salvage on Pediatric Craniocerebral Trauma
Overview
This study evaluates the impact of partial intraoperative cell salvage (ICS) on coagulation and blood transfusion needs in pediatric patients undergoing cerebral hematoma evacuation. Findings indicate that ICS significantly reduces allogeneic blood consumption and the incidence of postoperative coagulation disorders without adversely affecting standard coagulation indices.
Background
Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children, often requiring blood transfusions during surgical interventions. Intraoperative cell salvage (ICS) is a technique aimed at minimizing allogeneic blood exposure, yet its effects on coagulation in pediatric neurosurgery remain underexplored. Understanding the implications of ICS could enhance patient safety and optimize transfusion practices in this vulnerable population.
Data Highlights
Group
Allogeneic Blood Consumption
Coagulation Disorder Rate
Hypofibrinogenemia Rate
ICS
Lower
17.1% (after PSM)
Less frequent (P = 0.040)
ABL
Higher
39.0% (after PSM)
More frequent
Key Findings
ICS group had significantly lower allogeneic blood consumption compared to ABL group (P < 0.001).
No significant differences in postoperative coagulation indices (PT, APTT, INR, PLT, Hb, Hct) between groups (all P > 0.05).
Composite coagulation disorder rate was lower in the ICS group both before (19.0% vs. 44.7%; P = 0.008) and after PSM (17.1% vs. 39.0%; P = 0.049).
Hypofibrinogenemia (FIB < 1.5 g/L) was less frequent in the ICS group before (P = 0.014) and after PSM (P = 0.040).
Clinical outcomes such as operating time, ICU admission, intubation duration, and hospital stay did not differ significantly after PSM.
Clinical Implications
The use of partial ICS in pediatric craniocerebral trauma can effectively reduce the need for allogeneic blood transfusions and lower the incidence of postoperative coagulation disorders. Clinicians should consider integrating ICS into surgical protocols to enhance patient safety and optimize blood management strategies.
Conclusion
Partial intraoperative autologous blood salvage demonstrates potential benefits in reducing allogeneic blood use and coagulation complications in pediatric patients. Further prospective multicenter studies are warranted to validate these findings.
