Is Cell Salvage during C-section Beneficial?

Cell salvage did not lead to a statistically significant reduction in blood transfusion rates in all women who are at risk of hemorrhage during cesarean section.

Cell salvage was found to be statistically insignificant in the reduction of blood transfusion rates in all women undergoing cesarean section, reveals a new study.

Cell salvage is reinfusion of red blood cells that are lost during surgery. The study was published in PLOS Medicine by Khalid Khan from Queen Mary University of London, UK, and colleagues.

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‘Cell salvage did not minimize the use of donor blood transfusion in women who are at risk of hemorrhage during cesarean section.’

Excessive hemorrhage during cesarean sections, one risk of the procedure, requires treatment by transfusion of donated blood components.

In the new study, aiming to determine whether cell salvage could minimize the use of donor blood, researchers randomly assigned 3,028 women at risk of hemorrhage during cesarean section from 26 obstetric units to routine use of cell salvage (intervention group) or current standard of care without routine salvage use (control group).

Donor blood transfusion rates were 2.5 percent in the intervention group and 3.5% in the control group; the difference was not statistically significant (adjusted odds ratio 0.65; 95% confidence interval 0.42 to 1.01, p=0.056).

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In a planned subgroup analysis, the transfusion rate was lower in the intervention compared with control group for women undergoing emergency cesareans (3.0% vs 4.6%, adjusted odds ratio 0.58, 95% confidence interval 0.34 to 0.99), although additional research may be needed to confirm whether cell salvage could be effective in these women.

"There were around 75,250 cesareans carried out in 2013-14 in the NHS. Of these, around 42,500 were emergency cesareans, and these potentially stand to gain from cell salvage" the authors say.

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"The benefit will depend on the extent to which the potential benefit would represent good value for money."

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Source-Eurekalert