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 - Summary - 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
To determine whether partial intraoperative autologous blood reinfusion alters postoperative coagulation function compared with allogeneic transfusion alone in children undergoing cerebral hematoma evacuation.
Key Findings:
Allogeneic blood consumption was significantly higher in the ABL group (P < 0.001).
No significant intergroup differences in postoperative coagulation indices (PT, APTT, INR, PLT, Hb, Hct) or serum electrolytes (all P > 0.05).
Composite coagulation disorder rate was lower in the ICS group before (19.0% vs. 44.7%; P = 0.008) and after PSM (17.1% vs. 39.0%; P = 0.049).
Hypofibrinogenemia 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.
Interpretation:
Partial intraoperative autologous blood salvage significantly reduces allogeneic blood consumption and the incidence of postoperative coagulation disorders, without impairing standard coagulation indices or electrolyte balance, suggesting important clinical implications.
Limitations:
Retrospective design may introduce selection bias.
Findings are hypothesis-generating and require confirmation in prospective multicenter trials.
The retrospective nature may limit the generalizability of the results.
Conclusion:
Partial intraoperative autologous blood salvage in pediatric hematoma evacuation shows potential benefits in reducing allogeneic blood use and coagulation disorders.
