The efficacy, safety and cost-effectiveness of intra-operative cell salvage in high-bleeding-risk cardiac surgery with cardiopulmonary bypass: A prospective randomized and controlled trial

International Journal of Medical Sciences

Volumn 12, Issue 4, 2015, Pages 322-328

  Xie, Yihong ^a   Shen, Sheliang ^a   Zhang, Jun ^a   Wang, Wenyuan ^a   Zheng, Jiayin ^b  

^a ZHEJIANG PROVINCIAL PEOPLE'S HOSPITAL   (China)

^b PEKING UNIVERSITY   (China)

Author keywords

Autologous; Blood transfusion; Cardiac surgery; Operative blood salvage; Risk grade

Indexed keywords

FRESH FROZEN PLASMA; HEPARIN;

AGED; ALLOGENEIC ERYTHROCYTE TRANSFUSION; ARTICLE; BLOOD AUTOTRANSFUSION; BLOOD CLOTTING DISORDER; BLOOD CONSERVATION; CARDIOPULMONARY BYPASS; CHINA; CLINICAL EFFECTIVENESS; COMPARATIVE STUDY; CONTROLLED STUDY; COST EFFECTIVENESS ANALYSIS; ERYTHROCYTE TRANSFUSION; FEMALE; HEALTH CARE COST; HEART SURGERY; HUMAN; INCIDENCE; INTRAOPERATIVE CELL SALVAGE; KIDNEY DISEASE; LIVER FAILURE; LOW BLEEDING RISK CARDIAC SURGERY; MAJOR CLINICAL STUDY; MALE; OUTCOME ASSESSMENT; PATIENT SAFETY; POSTOPERATIVE HEMORRHAGE; PROSPECTIVE STUDY; RANDOMIZED CONTROLLED TRIAL; THROMBOCYTE TRANSFUSION; ADULT; ADVERSE EFFECTS; BLOOD LOSS, SURGICAL; BLOOD SALVAGE; BLOOD TRANSFUSION; COST BENEFIT ANALYSIS; ECONOMICS; MIDDLE AGED; PERIOPERATIVE PERIOD; RISK FACTOR; SAFETY; TREATMENT OUTCOME;

ADULT; AGED; BLOOD LOSS, SURGICAL; BLOOD TRANSFUSION; BLOOD TRANSFUSION, AUTOLOGOUS; CARDIAC SURGICAL PROCEDURES; CARDIOPULMONARY BYPASS; CHINA; COST-BENEFIT ANALYSIS; ERYTHROCYTE TRANSFUSION; FEMALE; HUMANS; MALE; MIDDLE AGED; OPERATIVE BLOOD SALVAGE; PERIOPERATIVE PERIOD; PROSPECTIVE STUDIES; RISK FACTORS; SAFETY; TREATMENT OUTCOME;

EID: 84926512204     PISSN: 14491907     EISSN: None     Source Type: Journal    
DOI: 10.7150/ijms.11227     Document Type: Article

References (24)

1. Bahrainwala ZS, Grega MA, Hogue CW, et al. Intraoperative hemoglobin levels and transfusion independently predict stroke after cardiac operations. Ann Thorac Surg. 2011; 91:1113-8.
2. Darby P, Kim N, Hare G, Tsui A, et al. Anemia increases the risk of renal cortical and medullary hypoxia during cardiopulmonary bypass. Perfusion. 2013;28:504-11.
3. Reyes G, Prieto M, Alvarez P, et al. Cell saving systems do not reduce the need of transfusion in low-risk patients undergoing cardiac surgery. Interact Cardiovasc Thorac Surg. 2011; 12:189-93.
4. Scrascia G, Rotunno C, Nanna D, et al. Pump blood processing, salvage and re-transfusion improves hemoglobin levels after coronary artery bypass grafting, but affects coagulative and fibrinolytic systems. Perfusion. 2012; 27:270-7.
5. Ferraris VA, Ferraris SP, Saha SP, Hessel EA 2nd, Haan CK, Royston BD, Bridges CR, Higgins RS, Despotis G, Brown JR, Society of Cardiovascular Anesthesiologists Special Task Force on Blood Transfusion, Spiess BD, Shore-Lesserson L, Stafford-Smith M, Mazer CD, Bennett-Guerrero E, Hill SE, Body S. Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists clinical practice guideline. Ann Thorac Surg. 2007; 83 (5 Suppl):S27-S86.
6. Dunning J, Versteegh M, Fabbri A, et al; EACTS Audit and Guidelines Committee. EACTS Audit and Guidelines Committee. Guideline on antiplatelet and anticoagulation management in cardiac surgery. Eur J Cardiothorac Surg. 2008; 34:73-92.
7. Djaiani G, Fedorko L, Borger MA, et al. Continuous-flow cell saver reduces cognitive decline in elderly patients after coronary bypass surgery. Circulation. 2007; 116:1888-95.
8. Klein AA, Nashef SA, Sharples L, et al. A randomized controlled trial of cell salvage in routine cardiac surgery. Anesth Analg. 2008; 107:1487-95.
9. Attaran S, McIlroy D, Fabri BM, et al. Intra-operative cell salvage in routine cardiac surgery is ineffective and not cost-effective and should be reserved for selected cases. Interact Cardiovasc Thorac Surg. 2011; 12:824-6.
10. Hardy JF, Perrault J, Tremblay N, et al. The stratification of cardiac surgical procedures according to use of blood products: a retrospective analysis of 1480 cases. Can J Anaesth. 1991; 38:511-7.
11. Parr KG, Patel MA, Dekker R, et al. Multivariate predictors of blood product use in cardiac surgery. J Cardiothorac Vasc Anesth. 2003; 17:176-81.
12. Weltert L, Nardella S, Rondinelli MB, et al. Reduction of allogeneic red blood cell usage during cardiac surgery by an integrated intra- and postoperative blood salvage strategy: results of a randomized comparison. Transfusion. 2013; 53:790-7.
13. Fergusson DA, Hébert PC, Mazer CD, et al; BART Investigators. A comparison of aprotinin and lysine analogues in high-risk cardiac surgery. N Engl J Med. 2008; 358:2319-31.
14. Djaiani G, Fedorko L, Borger MA, et al. Continuous-flow cell saver reduces cognitive decline in elderly patients after coronary bypass surgery. Circulation. 2007; 116:1888-95.
15. Vonk AB, Meesters MI, Garnier RP, et al. Intraoperative cell salvage is associated with reduced postoperative blood loss and transfusion requirements in cardiac surgery: a cohort study. Transfusion. 2013; 53: 2782-9.
16. Shore-Lesserson L, Manspeizer HE, DePerio M, et al. Thromboelastography- guided transfusion algorithm reduces transfusions in complex cardiac surgery. Anesth Analg. 1999; 88:312-9.
17. Ji HW, Ma L, Gao XR, Zhang Y, et al. Application of Thromboelastography in Cardiovascular Surgery. Chin J ECC. 2011; 9:170-2.
18. She-liang Shen, Jia-yin Zheng, Jun Zhang, et al. Comparison of Dexmedetomidine and Propofol for Conscious Sedation in Awake Craniotomy: A Prospective, Double-Blind, Randomized, and Controlled Clinical Trial. Annals of Pharmacotherapy. 2013, 47(11): 1391-1399.
19. Shander A, Hofmann A, Ozawa S, et al. Activity-based costs of blood transfusions in surgical patients at four hospitals. Transfusion. 2010; 50:753-65.
20. Niranjan G, Asimakopoulos G, Karagounis A, et al. Effects of cell saver autologous blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing cardiac surgery on- versus off-cardiopulmonary bypass: a randomised trial. Eur J Cardiothorac Surg. 2006; 30:271-7.
21. Shih RL, Cherng YG, Chao A, et al. Prediction of bleeding diathesis in patients undergoing cardiopulmonary bypass during cardiac surgery: viscoelastic measures versus routine coagulation test. Acta Anaesthesiol Sin. 1997; 35:133-9.
22. De Somer F. Understanding the delicate balance between bleeding and thrombosis: can we use it to our advantage? J Extra Corpor Technol. 2012; 44:13-5.
23. Serrick CJ, Scholz M, Melo A, et al. Quality of red blood cells using autotransfusion devices: a comparative analysis. J Extra Corpor Technol. 2003; 35:28-34.
24. Waters JH, Dyga RM, Waters JF, et al. The volume of returned red blood cells in a large blood salvage program: where does it all go? Transfusion. 2011; 51:26-32.