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Intramyocardial Cell Delivery: Observations in Murine Hearts
Published on: January 24, 2014
Intra-operative cell salvage in cardiac surgery may increase platelet transfusion requirements: a cohort study
A Z Al-Riyami1, M Al-Khabori1, B Baskaran2
1Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman.
Insights
The cell saver (CS) increases platelet transfusion needs in cardiac surgery patients and does not affect red blood cell (RBC) transfusion rates. Further research is needed to confirm these findings on CS use.
Area of Science:
- Cardiovascular Surgery
- Transfusion Medicine
- Critical Care Medicine
Background:
- The cell saver (CS) is commonly used in cardiac surgery to minimize red blood cell (RBC) transfusions.
- Its impact on allogeneic transfusion rates, patient morbidity, and mortality requires further investigation within specific healthcare settings.
Purpose of the Study:
- To evaluate the effect of cell saver (CS) utilization on allogeneic transfusion rates.
- To assess the influence of CS on postoperative morbidity and mortality in cardiac surgery patients.
Main Methods:
- A retrospective review of 673 cardiac surgery patients (2008-2013) at Sultan Qaboos University Hospital.
- Data collected included demographics, comorbidities, surgical details, and study end-points (transfusion, infection, renal failure, mortality).
- Multivariable logistic regression was used to adjust for baseline differences between CS and non-CS groups.
Main Results:
- The CS group (n=395) showed significantly higher rates of platelet (36% vs. 18%) and plasma (31% vs. 19%) transfusions compared to the non-CS group (n=278).
- Adjusted analysis indicated CS use increased the odds of platelet transfusion (OR 3.2) but not plasma transfusion (OR 1.6).
- No significant differences were observed in RBC transfusion rates (45% vs. 40%), renal failure (11% vs. 6%), infection (16% vs. 13%), or mortality (5% vs. 2%) between groups.
Conclusions:
- Cell saver (CS) use in cardiac surgery is associated with increased platelet requirements.
- CS does not appear to impact red blood cell transfusion rates, morbidity, or mortality in this population.
- Findings suggest caution regarding widespread CS adoption and highlight the need for larger studies to validate these outcomes.
Background And Objectives:
The cell saver (CS) has been widely utilized in cardiac surgery to reduce red blood cell (RBC) transfusion. We aim at examining its effect on the rate of allogeneic transfusion, morbidity and mortality in our population.
Materials And Methods:
Retrospective review of all patients operated at the Sultan Qaboos University Hospital between 2008 and 2013 was performed. Patients' demographics, comorbidities and surgical details were retrieved. Study end-points included blood transfusion, infection, renal failure and mortality. Baseline characteristics of both groups were compared and differences were adjusted for in the multivariable logistic regression.
Results:
A total of 673 patients were included (CS = 395, non-CS = 278). Baseline characteristics were similar except for systemic hypertension, congestive heart failure and use of cardiopulmonary bypass. The CS group had higher transfusion rates of platelets (CS 36% vs. non-CS 18%; P < 0·001) and plasma (CS 31% vs. non-CS 19%; P < 0·001). After adjusting for baseline differences, CS use increased the odds of receiving platelet transfusion (odds ratio (OR) 3·2; P < 0·001) but not of plasma transfusion (OR 1·6; P = 0·087). There was no difference in the rate of RBC transfusion (CS 45% vs. non-CS 40%; P = 0·212), renal failure (CS 11% vs. non-CS 6%; P = 0·139), infection (CS 16% vs. non-CS 13%; P = 0·434) and mortality (CS 5% vs. non-CS 2%; P = 0·146).
Conclusion:
The CS use increases platelet requirements and has no impact on the rate of RBC transfusion in our population. These findings warrant caution with generalized use and require larger studies to confirm its results.
