A comparison of intraoperative cell salvage use with cardiotomy suction in cardiothoracic surgery

Abstract

INTRODUCTION: Intraoperative cell salvage has been shown to be a safe and effective means of blood transfusion in elective surgery. Most cardiac units now employ cell salvage for complex cases but few use it routinely in all cardiac procedures requiring cardiopulmonary bypass.

AIM: To demonstrate if there was any haematological benefit of autologous transfusion using intra-operative cell salvage over single use of cardiotomy suction in patients undergoing cardiac surgery.

METHODS: All patients who had operations performed by the cardiac surgical team over a twenty month period formed part of this study including valve replacements and coronary artery bypass grafting.

The patients were divided into two groups; the cell saver group and the control group. The haematological variations of these patients' blood results were analysed preoperatively, immediately post-operatively and 24 hours post-operatively.

RESULTS: 451 patients were operated on in a 20 month period. 230 patients in the control group and 221 patients in the cell saver group. Intra-operative cell salvage demonstrated a better immediate post-operative haemoglobin level (10.31 g/dL) compared to the non-cell saver group (9.99 g/dL). The p-value was 0.003 after comparison between pre-operative haemoglobin and post-operative haemoglobin in the cell saver group.

CONCLUSION: Intra-operative cell salvage demonstrated a minimal increment in haemoglobin in the immediate post-operative period when compared with cardiotomy suction alone. Even though the improvement in haemoglobin is only significant until 24 hours post-operation, this is an overall increased benefit in the immediate recovery period.