Intraoperative Cell Savage, Infection and Organ Failure in Infective Endocarditis Patients-A Retrospective Single...

Area of Science:

• Cardiovascular Surgery
• Infectious Diseases
• Transfusion Medicine

Background:

• Surgery is necessary for approximately 50% of infective endocarditis cases.
• Bleeding and blood transfusions are common in these patients.
• Intraoperative cell salvage (ICS) use is limited in infective endocarditis despite potential transfusion benefits.

Purpose of the Study:

• To evaluate the safety and impact of intraoperative cell salvage with autologous blood retransfusion in patients undergoing surgery for infective endocarditis.
• To assess the association between ICS use and postoperative inflammatory markers and organ dysfunction.

Main Methods:

• Retrospective study of 335 patients with infective endocarditis (modified Duke criteria) between 2015 and 2020.
• Analysis included patients who underwent surgery with intraoperative cell salvage and autologous blood retransfusion.
• Linear regression analysis evaluated inflammation markers and organ dysfunction, including catecholamine dependency.

Main Results:

• Intraoperative cell salvage was used in 40.3% of cases, particularly in complex scenarios and reoperations.
• ICS was associated with a statistically significant but potentially clinically unimportant increase in postoperative white blood cell count.
• Organ dysfunction, hemodynamic instability, and lactate values were comparable between patients with and without ICS.

Conclusions:

• Intraoperative cell salvage effectively enhances autologous blood retransfusion in infective endocarditis surgery.
• ICS use shows minor effects on postoperative inflammatory markers and is not linked to increased hemodynamic instability or organ dysfunction.
• Restrictions on ICS use in infective endocarditis surgery should be reconsidered, with a need for prospective data.