Trial reportPLoS medicine2017
Cell salvage and donor blood transfusion during cesarean section: A pragmatic, multicentre randomised controlled trial (SALVO).
Trial report in PLoS medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Cell salvage for the management of postpartum haemorrhage.The Cochrane database of systematic reviews · 2024Pooled it
- Cell salvage for minimising perioperative allogeneic blood transfusion in adults undergoing elective surgery.The Cochrane database of systematic reviews · 2023Pooled it
- Intraoperative cell salvage as an effective intervention for postpartum hemorrhage-Evidence from a prospective randomized controlled trial.Frontiers in immunology · 2022Trial
- Maternal critical care infrastructure and organisational preparedness in Türkiye: a national analysis of the MaCriCare cross-sectional survey.Annals of medicine · 2026Article
- Barriers and facilitators to cell saver use in damage control surgery.Transfusion · 2026Article
- Article
- Evolving perspectives on blood transfusion in obstetric hemorrhage: a narrative review.Korean journal of anesthesiology · 2026Review
- Partly intraoperative cell salvage in pediatric craniocerebral trauma: effects on coagulation function, allogeneic blood requirements, and clinical outcomes - a propensity score-matched retrospective cohort study.Frontiers in pediatrics · 2026Article
- Individualized perioperative decision-making for intraoperative cell salvage in an Rh(D)-negative patient with placenta percreta: a case report.Frontiers in medicine · 2026Article
- Patient blood management in pregnancy, the peripartum, and the postpartum period.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2026Article
- Efficacy and cost-effectiveness of intraoperative cell salvage for patients with placenta previa during cesarean section: a retrospective comparison analysis.Open medicine (Warsaw, Poland) · 2026Article
- Effect of intraoperative cell salvage on postoperative blood transfusion demand outcomes in cesarean section with placenta previa: a retrospective study with propensity score matching analysis.BMC anesthesiology · 2025Article
- Cell Salvage in the Management of Postpartum Hemorrhage: A Comprehensive Review of the Current Literature.Cureus · 2025Review
- [Cell salvage in obstetrics-Background and practical implementation].Die Anaesthesiologie · 2024Review
- Strategies to prevent blood loss and reduce transfusion in emergency general surgery, WSES-AAST consensus paper.World journal of emergency surgery : WJES · 2024Review
- Association between routine cell salvage use for lower segment caesarean section and post-operative iron infusion and anemia.Archives of gynecology and obstetrics · 2024Article
- Routine use of cell salvage during cesarean section: A practice evaluation.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Clinical nursing value of predictive nursing in reducing complications of pregnant women undergoing short-term massive blood transfusion during cesarean section.World journal of clinical cases · 2024Article
- Management of Postpartum Haemorrhage.Turkish journal of anaesthesiology and reanimation · 2022Article
- How well does your massive transfusion protocol perform? A scoping review of quality indicators.Blood transfusion = Trasfusione del sangue · 2020Article
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Authors and funding
20 authors.
Funding
Abstract
backgroundExcessive haemorrhage at cesarean section requires donor (allogeneic) blood transfusion. Cell salvage may reduce this requirement. METHODS AND
findingsWe conducted a pragmatic randomised controlled trial (at 26 obstetric units; participants recruited from 4 June 2013 to 17 April 2016) of routine cell salvage use (intervention) versus current standard of care without routine salvage use (control) in cesarean section among women at risk of haemorrhage. Randomisation was stratified, using random permuted blocks of variable sizes. In an intention-to-treat analysis, we used multivariable models, adjusting for stratification variables and prognostic factors identified a priori, to compare rates of donor blood transfusion (primary outcome) and fetomaternal haemorrhage ≥2 ml in RhD-negative women with RhD-positive babies (a secondary outcome) between groups. Among 3,028 women randomised (2,990 analysed), 95.6% of 1,498 assigned to intervention had cell salvage deployed (50.8% had salvaged blood returned; mean 259.9 ml) versus 3.9% of 1,492 assigned to control. Donor blood transfusion rate was 3.5% in the control group versus 2.5% in the intervention group (adjusted odds ratio [OR] 0.65, 95% confidence interval [CI] 0.42 to 1.01, p = 0.056; adjusted risk difference -1.03, 95% CI -2.13 to 0.06). In a planned subgroup analysis, the transfusion rate was 4.6% in women assigned to control versus 3.0% in the intervention group among emergency cesareans (adjusted OR 0.58, 95% CI 0.34 to 0.99), whereas it was 2.2% versus 1.8% among elective cesareans (adjusted OR 0.83, 95% CI 0.38 to 1.83) (interaction p = 0.46). No case of amniotic fluid embolism was observed. The rate of fetomaternal haemorrhage was higher with the intervention (10.5% in the control group versus 25.6% in the intervention group, adjusted OR 5.63, 95% CI 1.43 to 22.14, p = 0.013). We are unable to comment on long-term antibody sensitisation effects.
conclusionsThe overall reduction observed in donor blood transfusion associated with the routine use of cell salvage during cesarean section was not statistically significant.
trial registrationThis trial was prospectively registered on ISRCTN as trial number 66118656 and can be viewed on http://www.isrctn.com/ISRCTN66118656.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.