Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 1:2022:3993452.
doi: 10.1155/2022/3993452. eCollection 2022.

The Effect of Cell Salvage on Bleeding and Transfusion Needs in Cardiac Surgery

Frixos Tachias  1 , Evangelia Samara  2 , Anastasios Petrou  3 , Agathi Karakosta  2 , Stavros Siminelakis  4 , Efstratios Apostolakis  4 , Petros Tzimas  2
Affiliations

The Effect of Cell Salvage on Bleeding and Transfusion Needs in Cardiac Surgery

Frixos Tachias et al. Anesthesiol Res Pract. .

Abstract

Introduction: Cell salvaging is well established in the blood management of cardiac patients, but there remain some concerns about its effects on perioperative bleeding and transfusion variables. This randomized controlled study investigated the potential effects of the centrifuged end-product on bleeding, transfusion rates, and other transfusion-related variables in adult cardiac surgery patients submitted to extracorporeal circulation.

Materials and methods: Patients were randomly chosen to receive (cell-salvage group, 99 patients) or not to receive (control group, 110 patients) the centrifuged product of a cell salvage apparatus. Bleeding and transfusion rates according to the universal definition of perioperative bleeding (UDPB) classification, postoperative hemoglobin, coagulation, and oxygenation indices were recorded and compared between the groups.

Results: Both groups had almost identical bleeding and transfusion rates (median value: 2 units of red blood cells (RBC) and no units of fresh frozen plasma (FFP) and platelets (PLT) for both groups, p > 0.05). Patients in the cell-salvage group presented slightly higher hemoglobin concentrations (10.6 ± 1.1 vs. 10.1 ± 1.7 g/dL, p < 0.05, respectively) and a tendency towards better oxygenation indices (PaO2/FiO2: 241 ± 94 vs. 207 ± 84, p=0.013) in the postoperative period albeit with a tendency for prolongation of prothrombin time (INR: 1.31 ± 0.18 vs. 1.26 ± 0.12, p=0.008).

Conclusion: Within the study's constraints, the perioperative use of the cell salvage concentrate does not seem to affect bleeding or transfusion variables, although it could probably ameliorate postoperative oxygenation in adult cardiac surgery patients. A tendency to promote coagulation disturbances was detected.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Scheme 1
Scheme 1
Recruitment and randomization of patients in cell salvage (CS) and control (C) groups.
Figure 1
Figure 1
Perioperative universal definition of perioperative bleeding (UDPB) classification ((f): fisher's exact test, (x): χ2 test).
Figure 2
Figure 2
Perioperative transfusions (FFP: fresh frozen plasma, PLT: platelets, RBC: red blood cells, (f): fisher's exact test).
See this image and copyright information in PMC

References

    1. Klein A., Agarwal S., Cholley B., et al. A survey of patient blood management for patients undergoing cardiac surgery in nine European countries. Journal of Clinical Anesthesia . 2021;72 doi: 10.1016/j.jclinane.2021.110311.110311 - DOI - PubMed
    1. van Klarenbosch J., van den Heuvel E. R., van Oeveren W., de Vries A. J. Does intraoperative cell salvage reduce postoperative infection rates in cardiac surgery? Journal of Cardiothoracic and Vascular Anesthesia . 2020;34(6):1457–1463. doi: 10.1053/j.jvca.2020.01.023. - DOI - PubMed
    1. Wang H., Zheng W., Fang W., et al. Safety, efficacy, and cost-effectiveness of intraoperative blood salvage in OPCABG with different amount of bleeding: a single-center, retrospective study. Journal of Cardiothoracic Surgery . 2018;13(1):p. 109. doi: 10.1186/s13019-018-0794-6. - DOI - PMC - PubMed
    1. Yao Y. T., Yuan X., He L. X., et al. Patient blood management: single center evidence and practice at Fuwai hospital. Chinese Medical Sciences Journal . 2022 doi: 10.24920/004035. - DOI - PubMed
    1. Koçyiğit M., Gullu A. U., Senay S. Postoperative atrial fibrillation reduced by intraoperative and postoperative cell saver system in coronary artery bypass graft surgery. Turkish Journal of Anaesthesiology & Reanimation . 2022;50(3):173–177. doi: 10.5152/TJAR.2022.21121. - DOI - PMC - PubMed

LinkOut - more resources