Evidence map›Paper›PMID 39524169›Full record

ArticleCureus2024

Implementing a Labor and Delivery Cell Salvage Protocol in Patients at Increased Risk of Hemorrhage: A Pilot Study.

Camila Cabrera, Nicola F Tavella, Cody P Goldberger, Chioma Iwelumo, Eric Mitchell, David Lubell, Angela T Bianco, Daniel Katz, Rebecca H Jessel

Abstract read
In one paragraph

Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Camila CabreraMaternal-Fetal Medicine, Winnie Palmer Hospital for Women and Babies, Odessa, USA.
Nicola F TavellaObstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York City, USA.
Cody P GoldbergerObstetrics and Gynecology, New York University Grossman School of Medicine, New York City, USA.
Chioma IwelumoObstetrics and Gynecology, Mount Sinai West Medical Center, New York City, USA.
Eric MitchellObstetrics and Gynecology, Mount Sinai Hospital, New York City, USA.
David LubellObstetrics and Gynecology, Mount Sinai Hospital, New York City, USA.
Angela T BiancoObstetrics and Gynecology, Mount Sinai Hospital, New York City, USA.
Daniel KatzAnesthesiology, Mount Sinai Hospital, New York City, USA.
Rebecca H JesselObstetrics and Gynecology, New York University Langone Hospital - Brooklyn, Brooklyn, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostpartum hemorrhage (PPH) contributes significantly to maternal morbidity and mortality. The use of cell salvage has been implemented in operating rooms across the world, but only a limited number of institutions have protocols for use of cell salvage during vaginal hemorrhage at the time of vaginal delivery. Observations suggest that blood salvaged from vaginal delivery is comparable to blood salvaged during cesarean delivery. Using pre-validated protocols of cell salvage, we sought to assess the feasibility and potential benefit of implementing cell salvage in our Labor and Delivery unit in all patients at high risk of hemorrhage.

methodsThis was a prospective pilot study conducted from April 2022 to December 2022 on the Labor and Delivery floor at Mount Sinai Hospital in New York City. A total of 50 participants were identified for cell salvage after vaginal delivery during the study period. The mean age of participants was 34.4 years (SD 5.5). We utilized a cell salvage technique at the time of vaginal delivery in patients at high risk of PPH. We employed simple descriptive statistics and examined sums and percentages (and means and standard deviations, where appropriate). A simple equation was used to determine the average cell salvaged volume in each delivery and describe potential values. The HEMAsavR™ device (Ecomed Solutions, Mundelein, IL, USA) was used as a standby system to be used at the time of the vaginal delivery.

resultsFifty participants were identified for the cell salvage protocol as described. Despite a diversity of clinical risk factors, the sample consisted of predominately non-Hispanic White patients. The mean quantitative blood loss of cell salvaged samples was 157.2 mL (SD 153.0). We identified that, on average, >33% of vaginally shed blood could be used for cell salvage and improve patient blood management.

conclusionThe implementation of cell salvage in our Labor and Delivery unit was feasible and easy to perform. We identified that a significant volume of blood would be available for cell salvage. Further studies should be done to evaluate the benefit of cell salvage to improve postpartum recovery.

Indexed as

alternative transfusion strategiesautologous blood transfusionsblood salvageobstetric anesthesiapostpartum hemorrhage

Identifiers

PMID39524169
PMCPMC11549931

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