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Review
. 2024 Oct 11;13(20):6073.
doi: 10.3390/jcm13206073.

Evaluation of Red Blood Cell Biochemical Markers and Coagulation Profiles Following Cell Salvage in Cardiac Surgery: A Systematic Review and Meta-Analysis

Rocío Cáceres-Matos  1 , Manuel Luque-Oliveros  2 , Manuel Pabón-Carrasco  1
Affiliations
Review

Evaluation of Red Blood Cell Biochemical Markers and Coagulation Profiles Following Cell Salvage in Cardiac Surgery: A Systematic Review and Meta-Analysis

Rocío Cáceres-Matos et al. J Clin Med. .

Abstract

Background: Individuals undergoing cardiac surgery face an increased risk of bleeding, as well as alterations in biochemical and coagulation patterns. Therefore, assessing the effectiveness of systems such as Cell Salvage is necessary to prevent potential surgical complications. Objective: To evaluate the efficacy of Cell Salvage in relation to the biochemical parameters of the red blood series and coagulation, as well as the risk of hemorrhage. Methods: A systematic review, accompanied by a meta-analysis, was executed via an extensive literature exploration encompassing Medline, CINAHL, Scopus, Web of Science, and the Cochrane Library. The inclusion criteria comprised studies in English or Spanish, without year restrictions, conducted in adults and with a randomized controlled trial design. Results: Twenty-six studies were included in the systematic review, involving a total of 2850 patients (experimental group = 1415; control group = 1435). Cell Salvage did not demonstrate superior outcomes compared to allogeneic transfusions in the management of post-surgical hemorrhage, as well as in total blood loss, platelet count, fresh frozen plasma, and fibrinogen. However, Cell Salvage showed a greater effectiveness for hemoglobin (moderate evidence), hematocrit (low evidence), post intervention D-dimer (low evidence), and some coagulation-related parameters (low evidence) compared to allogeneic transfusions. Finally, better results were found in the control group for INR parameters. Conclusions: The use of the Cell Salvage system holds high potential to improve the postoperative levels of biochemical and coagulation parameters. However, the results do not provide definitive evidence regarding its effectiveness for hemorrhage control, platelet count, fresh frozen plasma, and fibrinogen. Therefore, it is recommended to increase the number of studies to assess the impact of the Cell Salvage system on improvements in the red blood cell count and patient coagulation patterns. In addition, protocols should be homogenized, and variables such as the sex of the participants should be taken into account.

Keywords: biochemical markers; blood coagulation; blood transfusion; blood transfusion autologous; operative blood salvage; red blood cell; surgical blood loss.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram that illustrates the review process.
Figure 2
Figure 2
Forest plot depicting hemorrhage at different time slices.
Figure 3
Figure 3
Forest plot presenting hemoglobin at different time slices.
Figure 4
Figure 4
Forest plot presenting hematocrit at different time slices.
Figure 5
Figure 5
Forest plot presenting the aPPT and aPPT ratio over time.
Figure 6
Figure 6
Forest plot presenting PT and TT over time.
Figure 7
Figure 7
Forest plot presenting platelet count over time and number of fresh frozen plasma transfusions.
See this image and copyright information in PMC

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