Intraoperative Cell Salvage is Associated with Reduced Postoperative Blood Loss and Transfusion Requirements in Cardiac Surgery: a Cohort Study.

Source
Departments of Cardio-thoracic Surgery, Institute for Cardiovascular Research, Amsterdam, Netherlands; Departments of Anesthesiology, Institute for Cardiovascular Research, Amsterdam, Netherlands; Department of Epidemiology and Biostatistics, Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands.

Abstract

BACKGROUND:
This study investigated whether implementation of cell salvage of shed mediastinal and residual blood in all patients undergoing low-to-moderate-risk cardiac surgery reduces the need for allogeneic red blood cell (RBC) transfusion compared to patients not subjected to cell salvage.

STUDY DESIGN AND METHODS:
This retrospective cohort study included patients undergoing low-to-moderate-risk cardiac surgery with cardiopulmonary bypass without (control; n = 531) or with cell salvage (n = 433; Autolog, Medtronic). Study endpoints, including 24-hour blood loss and RBC requirements, were evaluated using adjusted logistic regression.

RESULTS:
Baseline characteristics were similar between groups. The cell saver group received 568 ± 267 mL of autologous blood. Median number of allogeneic RBC transfusions was higher in the control group (2 [1-5]) compared with the cell salvage group (1 [0-3]; p 

CONCLUSION:
The use of cell salvage throughout the entire procedure reduces postoperative blood loss and allogeneic RBC transfusion. These findings advocate implementation of cell salvage in all patients undergoing on-pump cardiac surgery, irrespective of anticipated surgery-related blood loss.

Transfusion. 2013 Feb 27. doi: 10.1111/trf.12126. [Epub ahead of print]

Author: 
Vonk AB, Meesters MI, Garnier RP, Romijn JW, van Barneveld LJ, Heymans MW, Jansen EK, Boer C.
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Article date: 
Monday, April 15, 2013