Effectiveness of Intraoperative Autotransfusion in Mild-bleeding Surgery: a Randomized Controlled Trial

  Objective  To investigate the effectiveness of intraoperative autotransfusion (IAT) in improving tissue oxygenation and postoperative recovery in patients undergoing mild-bleeding surgery.

  Methods  We selected patients scheduled for posterior lumbar surgery at Peking Union Medical College Hospital from December 2011 to April 2012, at American Soceity of Anesthesiologists grade Ⅰ-Ⅱ, and with estimated blood loss less than 20% of their blood volume. The patients were randomly divided into the IAT group (given salvaged autologous blood) and the control group (given equal volume of colloid solution instead). Hemoglobin (Hb) level, lactate level, and cerebral oxygen saturation before, during, and after the surgery were compared between the two groups. Postoperative recovery indexes of the 2 groups were compared, including body temperature, chief complaint, wound healing, ambulation time, and postoperative length of stay.

  Results  Thirty-eight patients were enrolledand randomly divided into the IAT group (n=19) and the control group (n=19). In the IAT group, postoperative half-hour and postoperative 1-day Hb levels were (116.5±10.7)g/L and (115.4±12.3)g/L, respectively, both significantly higher than the intraoperative level(106.6±12.6)g/L; P=0.001, P=0.004; while no such significant differences were found in the control group (P > 0.05). Lactate level was significantly elevated at postoperative half-hour compared with preoperative level in the control group(2.5±1.0)mmol/L vs. (1.3±0.6)mmol/L, P=0.016, while the trend was absent in the IAT group. There were no significant differences in postoperative Hb level, lactate level, and cerebral oxygen saturation between the two groups (P > 0.05), nor in any of the postoperative recovery indexes (P > 0.05).

  Conclusion  The use of IAT in healthy adult patients undergoing surgery with estimated small blood loss could improve early tissue oxygenation after the surgery, but with no significant influence on postoperative recovery.