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Autotransfusion with cell saver for off-pump coronary artery bypass surgery: a randomized trial
Sune Damgaard1, Daniel A Steinbrüchel
1Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Denmark. sunedamgaard@dadlnet.dk
Objectives:
Off-pump coronary surgery reduces transfusions, however, many patients still receive blood. This trial aims to clarify the effect of using a cell saver intraoperatively.
Design:
In 60 patients shed blood was collected in the cell saver reservoir intraoperatively; randomization and processing or discharge were performed immediately after surgery.
Primary Outcome Measures:
proportion of patients receiving allogeneic blood, and average number of units per patient.
Secondary Outcome Measures:
blood loss, hemoglobin levels, complications, and costs.
Results:
Cell saver group versus control group; received transfusions: 17/30 vs. 14/29 (p = 0.28), allogeneic units: median 1 (interquartile range 0 - 2) vs. 2 (IQR 0 - 7) (p = 0.06), intraoperative net blood loss: median 300 ml (IQR 193 - 403) vs. 610 ml (IQR 450 - 928) (p < 0.001). Control group patients had more complications leading to transfusion. Hemoglobin levels and costs were comparable between groups.
Conclusions:
Use of cell saver reduced intraoperative net blood loss and seemed to reduce transfusions by 1 unit per patient, however, this was probably attributable to more complications leading to transfusion in the control group. In the future larger trials are necessary.
