Related Experiment Videos
The benefit of the Hemonetics cell saver apparatus during cardiac surgery
R I Hall1, I M Schweiger, D C Finlayson
1Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA.
Insights
Using a cell saver apparatus (CSA) during coronary artery bypass graft surgery reduced homologous blood needs and bleeding risks. However, the CSA did not prove cost-effective due to initial expenses.
Area of Science:
- Cardiovascular Surgery
- Transfusion Medicine
- Medical Device Technology
Background:
- Coronary artery bypass graft (CABG) surgery often necessitates blood transfusions.
- Cell saver apparatus (CSA) technology aims to reinfuse a patient's own blood during surgery.
- The efficacy and cost-effectiveness of CSA in CABG procedures require evaluation.
Purpose of the Study:
- To assess the impact of CSA use on homologous blood requirements in CABG patients.
- To determine if CSA increases the incidence of post-surgical bleeding.
- To evaluate the cost-effectiveness of employing a CSA in CABG surgery.
Main Methods:
- Retrospective chart review of 155 patients undergoing CABG surgery.
- Comparison of two groups: Group 1 (n=99) with CSA-processed red blood cells and homologous blood, and Group 2 (n=56) with only homologous blood.
- Analysis of homologous blood product usage, post-surgical bleeding incidence, and cost-effectiveness.
Main Results:
- Patients using CSA (Group 1) showed significantly reduced homologous blood requirements within 24 hours post-surgery (0.5 +/- 1.0 vs 1.3 +/- 1.8 units; P < 0.05).
- A higher proportion of patients in Group 1 required no transfusions (45 vs 8; P < 0.05).
- No increased risk of major hemorrhage was observed in the CSA group; however, CSA utilization was not cost-effective when capital costs were included.
Conclusions:
- Cell saver apparatus (CSA) use in CABG surgery is safe, with no elevated risk of bleeding.
- CSA effectively reduces the need for homologous blood transfusions in CABG patients.
- Despite benefits in blood conservation, CSA adds to the overall cost of the CABG procedure.
Abstract:
This retrospective chart review of 155 patients having coronary artery bypass graft surgery (CABG) over a two-month period determined whether the use of a cell saver apparatus (CSA) (1) reduced or increased the requirements for homologous blood; (2) increased the incidence of post-surgical bleeding; (3) was cost-effective. Two groups of patients were identified. Group 1 (n = 99) received both CSA processed red blood cells and homologous blood components. Requirement for homologous blood products was reduced in the first 24 hr after surgery (0.5 +/- 1.0 vs 1.3 +/- 1.8 units; P less than 0.05) when compared with Group 2 (n = 56) in whom only homologous blood products were utilized. More patients in Group 1 had no transfusion requirements (45 vs 8; P less than 0.05) and there was no increased risk of major haemorrhage. When the capital costs are included, utilization of the CSA was not cost-effective. We conclude that utilisation of a CSA was safe, with no increased risk of bleeding, reduced requirements for homologous blood transfusions, but added to the cost of the procedure.