Is use of a Continuous Autotransfusion System beneficial in emergency abdominal aortic aneursym (AAA) surgery?

The impact of blood component transfusion practices on patient survival after abdominal aortic aneurysm surgery

BACKGROUND

The aim of the present study was to investigate the blood transfusion practice in patients operated for abdominal aortic aneurysm (AAA) with special emphasis on massive transfusion in cases with rupture.

MATERIAL AND METHODS

From a database, 504 patients operated for AAA were stratified into 2 groups; an early transfusion period (1992-1999) and a late transfusion period (2000-2008) to evaluate the changes in transfusion practices over the course of time.

RESULTS

Patients operated for nonruptured AAA (n = 330) showed a decreased mortality rate from 4% (early transfusion period) to 1% (late transfusion period) without significant changes in the transfusion practices. In patients operated for ruptured AAA (n = 174) an unexpected low mortality rate was found compared to the 30-day mortality reported in earlier studies. The transfusion practices in ruptured AAA surgery showed a significant increase in platelet use and change of fresh frozen plasma: red blood cell ratio from 0.8 to 0.9 between the early and the late transfusion period.

CONCLUSION

The present database study shows that the operating mortality for AAA surgery has declined during the past decades. The cause of the decline in mortality in patients with ruptured AAA was interpreted as partly due to a modern blood component therapy.