Intraoperative cell salvage in ruptured abdominal aneurysms

Aim. The aim of this study was to evaluate the impact of intraoperative cell salvage (ICS) on the early outcome after open repair (OR) of ruptured abdominal aortic aneurysm (rAAA). Methods. This is a retrospective review of 73 consecutive patients who underwent emergency OR of infiarenal rAAA with ICS between 2005 and 2008 (Group tr), compared to 5l repairs from 21lll2-2ll1l4 with no ICS (Group II). In addition, a transfusion protocol of platelets and tiesh frozen plasma (FFP) administration on admission and during surgerv was adopted in patients in Group I to maintain coagulation conrpetence. Results. ICS reduced bank blood demand by 63.6Vc (from I I to 4 units, P<0.001) compared to controls, and had a strong impact on rates of postoperative cornplications (P=0.05), or death (43.8o/o t',s.52.97c, P<0.05) or in-hospital LOS (P<0.07) in these patients. Patients surviving in Group I had significantly higher postoperative haemoglobin level (11.5 r'.r'. 9.6 gl dL, P<0.05) and platelet count (267 v"s.95 x lOeL, P<0.001 ), a shorter APTT (31 s r'.s. 47 s. P<0.05) and a lower INR (1.3 r'.r'. 2.1, P<0.01) than patients who died postoperatively. ICS volume was significantly higher in patients with suprarenal aortic clamping and in those who had bifurcated grafting reconstruction (P<0.05), but amount of red blood cells (RBC) collected did not influence outcome.