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[Cell saver devices in coronary revascularization surgery without extracorporeal circulation reduce transfusion
A Ysasi1, M J Trujillo, I D Tuesta
1Servicio de Cirugía Cardíaca del Hospiten Rambla, Tenerife.
Insights
Routine use of cell saver devices during off-pump coronary artery bypass surgery significantly reduces the need for blood transfusions. This method is safe and effective, especially when blood availability is a concern.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Transfusion Medicine
Context:
- Off-pump coronary artery bypass (OPCAB) surgery is a complex procedure.
- Minimizing blood loss and transfusion requirements is crucial for patient outcomes.
- Cell saver devices are used to reinfuse a patient's own blood lost during surgery.
Purpose:
- To evaluate the efficacy of cell saver devices in reducing transfusion needs in OPCAB surgery.
- To compare transfusion requirements between patients managed with and without cell saver devices.
Summary:
- A retrospective study analyzed 56 patients undergoing OPCAB surgery.
- The cell saver group (28 patients) showed significantly fewer transfusions (6 vs. 18) compared to the control group (28 patients).
- Mean packed red blood cell transfusion volume was lower in the cell saver group (1.2 L vs. 2.5 L).
Impact:
- Routine cell saver use in OPCAB surgery effectively reduces postoperative transfusions.
- The cell saver device is associated with no increased risk of adverse events or mortality.
- This technology is particularly valuable in settings with limited blood transfusion availability.
Objectives:
To analyze the effectiveness of a cell saver device in reducing transfusion requirements in patients undergoing off-pump coronary artery bypass surgery.
Patients And Methods:
Fifty-six consecutive ASA class 4-5 patients who underwent coronary surgery without extracorporeal circulation in our cardiac surgery department between June 2004 and January 2005 were included in this retrospective study; the series comprised 28 patients who received conventional management (control group) without use of the cell saver device and 28 who received cell saver treatment. Variables analyzed were preoperative and discharge hemoglobin levels and hematocrit values, age, weight, height, ejection fraction, packed red blood cells transfused, exitus, and adverse events.
Results:
The groups were similar with respect to preoperative characteristics. Fewer patients in the cell saver group required transfusions (6 vs 18 in the control group; relative risk 0.33, 95% confidence interval, 0.16-0.71). The mean amount of packed red cells transfused was greater in the control group than in the cell saver group (2.5 L vs 1.2 L, P = 0.03). No deaths or adverse events occurred in either group.
Conclusions:
The routine use of a cell saver device during off-pump coronary artery bypass surgery reduces the need for postoperative transfusions and is not associated with adverse events. Cell saver devices should be used routinely, especially in situations where the ability to provide blood transfusions may be compromised.
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