AI Article Synopsis
- The study compares the effectiveness of fresh whole blood (FWB) versus blood component transfusions in improving outcomes for patients post spinal deformity surgery.
- Included were 65 patients, ages around 14, who were randomly assigned to receive either FWB or blood components after significant blood loss during surgery.
- Results showed FWB led to better clinical outcomes, such as shorter oxygen dependence, better arterial pH, lower inflammatory markers, and reduced hospital stay compared to blood component transfusions.
- The findings suggest that using FWB could enhance recovery after major spinal surgeries, warranting further research for validation.
Article Abstract
Purpose: To compare the effectiveness of fresh whole blood (FWB) and blood component transfusion in improving clinical outcome and serological parameters in the early postoperative period following spinal deformity surgery.
Methods: Patients undergoing major spinal deformity surgeries involving ≥ 6 levels of fusion and expected blood loss ≥ 750 ml between September 2017 and August 2018 were included in the study. The patients were randomized into two groups: FWBG and CG, receiving fresh whole blood and component transfusions, respectively.
Results: A total of 65 patients with spinal deformities of different etiologies were included. The mean age was 14.0 and 14.9 years in FWB and CG, respectively. All other preoperative parameters were comparable. The mean fusion levels and surgical time were 11.1 and 221.20 min in FWB, as compared with 10.70 and 208.74minutes in CG, respectively. Intraoperative blood losses were 929 ml (FWBG) and 847 ml(CG), and the mean volumes of transfusion were 1.90 (FWBG) and 1.65 units (CG). FWBG was significantly superior to CG in the following clinical and laboratory parameters: duration of oxygen dependence [36.43 (FWBG) vs. 43.45 h (CG); P = 0.0256], mean arterial pH [7.442 (FWBG) vs. 7.394 (CG); p < 0.001], interleukin-6 [30.04 (FWBG) vs. 35.10 (CG); p < 0.019], mean duration of HDU stay [40.6 hours (FWBG) vs 46.51 hours (CG); p = 0.0234] and postoperative facial puffiness [7/30 in FWBG vs. 18/35 (CG) (P < 0.02)].
Conclusion: FWB transfusion can potentially improve the immediate postoperative outcome in patients undergoing major spinal deformity surgeries by reducing the duration of intensive care unit stay and oxygen dependence. The other potential benefits of this practice, based on our study, include a reduced inflammatory response (reduced lactate and IL-6) and postoperative facial puffiness. However, further large-scale validation studies in future are necessary to precisely determine the role of FWB in spine surgeries.
Level Of Evidence Ii: Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7962424 | PMC |
| http://dx.doi.org/10.1007/s00586-021-06798-0 | DOI Listing |
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