Table 1 Current studies relating to the use of blood conservation devices in critical care
From: Blood conservation devices in critical care: a narrative review
Study and year of publication | Design | Outcome |
|---|---|---|
Silver - 1993 [11] | Prospective, randomized crossover comparing the Safedraw device and conventional arterial line. | 31 patients enrolled, study period 7 days. |
Over 7-day period, the control group had a larger blood discard volume by an average of 156.8 ml (p < 0.001). | ||
Peruzzi - 1993 [21] | Prospective, randomized, controlled trial comparing the VAMP system to control. | 100 patients enrolled, mean study period 4 days. |
Total volume of blood discarded significantly lower in the VAMP group (19.4 ml vs. 103.5 ml, p < 0.001). | ||
Hb decreased by 1.4 g/dL in the control vs. 1 g/dL in the VAMP group (p = nonsignificant). Transfusion requirements similar in both groups –no transfusion protocol. | ||
Peruzzi - 1996 [22] | Prospective, randomized trial comparing microbial contamination between the VAMP and Safedraw device. | 40 patients studied for an average of 3 days. |
No difference in contamination rates between the two devices. | ||
No catheter-related infections | ||
Thorpe - 2000 [23] | Prospective, randomized trial comparing VAMP device to conventional arterial line. | 100 patients followed for 15 days. |
No significant difference in Hb concentration or transfusion requirements between the two groups. Mean Hb remained >10 throughout study - no transfusion protocol. | ||
MacIsaac - 2003 [24] | Randomized, unblinded, control trial comparing VAMP to control. | 160 patients, mean study period 3 days. |
Total volume of blood discarded significantly lower in the VAMP group (1 ml vs. 62 ml, p < 0.001). | ||
No significant change in Hb concentration between groups but unadjusted for transfusion. | ||
Fewer patients transfused within VAMP group (17 vs. 30 p = 0.04)- no transfusion protocol | ||
Mahdy - 2009 [25] | Prospective, randomized, unblinded controlled clinical study. Comparing VAMP plus paediatric vials to control plus adult vials. | 39 patients, study period 3 days |
Total volume of blood discarded significantly less in the VAMP group (0 ml vs. 25 ml, p < 0.001) | ||
No statistical difference in fall of Hb concentration (0.79 vs. 1.3 g/dL, p = 0.09) - no patient required transfusion. | ||
Rezende - 2010 [26] | Prospective, randomized, controlled trial comparing transfusion rates and Hb loss between VAMP system and control. | 127 patients followed for 14 days. |
Smaller decline in Hb within the VAMP group (p = 0.03) - no difference in transfusion rate; transfusion threshold 7 g/dL. | ||
Mukhopadhyay - 2010 [27] | Before and after intervention study assessing the impact of a restrictive transfusion strategy when comparing VAMP to control. | 250 patients followed for 28 days or until discharge from ICU. |
Smaller decline in Hb within the VAMP group (1.44 vs. 2.13 g/dL, p = 0.02) | ||
VAMP group required less transfusions (0.068 vs. 0.131 units/patient/day, p = 0.02); transfusion threshold of 7.5 g/dL. | ||
Oto - 2011 [28] | Prospective, randomized study comparing bacterial contamination between VAMP and control. | 216 patients followed for a median of 4 days. |
No statistically significant change in tip colonization between the two groups. No catheter-related infections. |