Should the Cell Saver Autotransfusion System Be Routinely Used in Elective Aortic Surgery?

Serrano, Francisco; Moñux, Guillermo; Aroca, Manuel

doi:10.1007/s100169910118

Cited by 15 publications

(11 citation statements)

References 16 publications

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“…The higher cost was observed in Group B, R$ 394.00 more. Several authors have also come to this conclusion [7][8][9]11] and, therefore, its indication has been made for specific cases in which bleeding is above normal [10]. However, we must take into consideration that the group using CS, 28 patients did not have UPRBC infusionn infusion, the total of 1.25 RBC / patient / hospitalization, and in Group A, 4.31.…”

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

“…The Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists [4], in its guidelines for 2007, considered as class I the use of CS. However, several authors have shown that the use of CS is not as beneficial as stated [5,6] and is not cost-effective [7][8][9].In order to clarify this issue, the authors devised this work, which aims to verify that the primary use of CS in cardiovascular surgery with cardiopulmonary bypass (CPB), is cost-effective. As a secondary objective, we sought to identify a reduction in the use of units of UPRBC in patients who used CS, and morbidity resulting from the use of this protocol.…”

mentioning

confidence: 99%

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The use of cell saver system in cardiac surgery with cardiopulmonary bypass

Almeida¹,

Leitão²

2013

Revista Brasileira De Cirurgia Cardiovascular

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Rev Bras Cir Cardiovasc 2013;28(1):76- Abstract Introduction: The use of cell saver (CS) in cardiac surgery is proposed to reduce the use of units of packed red blood cells stored (UPRBC), which increases morbidity, mortality and causes inflammatory reactions.Objective: The objective is to evaluate whether the use of CS decreases the use UPRBC, is cost / effective and beneficial to the patient.Methods: In a prospective study, between November 2009 and October 2011, 100 consecutive patients who underwent cardiovascular surgery with CPB, hemodilution and hemofiltration, were enrolled. Patients were divided into group 1 (no CS) and 2 (CS). The criteria for the replacement of RBC were hemodynamic instability and hemoglobin (Hb) <7-8g/dl. Demographic data, as well as Hb and hematocrit, mediastinal drainage, number of URBC and CPB, ICU and hospital time, were analysed.Results: In groups 1 and 2 the average age was 64.1 and 60.6 years; predominantly male; the logistic EuroSCORE 10.3 and 9.4; mortality 2% and 4%. Group 2 had a higher incidence of reoperations (12% versus 6%), but the average of UPRBC used (4.31 versus 1.25) and mean length of hospital stay (10.8 versus 7.4 days) was lower. Univariate and multivariate analysis, were performed, which showed no statistically significant values, except in the use of UPRBC. The relationship between the CS and the cost of RBC was not cost / effective and length of stay was shorter.Conclusion: The use of CS decreases the number of used UPRBC, is not cost / effective but has shown benefits for patients. Descriptors INTRODUCTIONSeveral methods have been used to decrease the use of homologous blood with the progress and increased knowledge of the pathophysiology of cardiopulmonary bypass. This has been a path, with the highest incidence of use in patients for religious reasons and those who do not wish to make use of units of stored packed red blood cells (UPRBC). The use of this strategy varies from services to services in different continents, between 15% and 60% [1].In recent years, efforts have been made to decrease more and more the use of homologous blood, with recovery of autologous blood during surgery and sometimes even in the postoperative period [2], along with a more hemostasis strict protocols throughout the surgical procedures. Cell savers machines (CS) have been used [3] in adult patients with high risk of bleeding, due to the fact that they decrease the inflammatory response to cardiopulmonary bypass. The Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists [4], in its guidelines for 2007, considered as class I the use of CS. However, several authors have shown that the use of CS is not as beneficial as stated [5,6] and is not cost-effective [7][8][9].In order to clarify this issue, the authors devised this work, which aims to verify that the primary use of CS in cardiovascular surgery with cardiopulmonary bypass (CPB), is cost-effective. As a secondary objective, we sought to identify a reduction in the use of units of UPRBC in patien...

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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The use of cell saver system in cardiac surgery with cardiopulmonary bypass

Almeida¹,

Leitão²

2013

Revista Brasileira De Cirurgia Cardiovascular

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“…[16] Ototransfüzyon cihazı kullanımı aşırı kanamalı durumlarda, nadir bulunan kan gruplu hastaların ameliyatında, acil cerrahi girişim-lerde ve hipersensitivite durumlarında çok faydalıdır. [17] Ototransfüzyon sisteminin kullanımına bağlı olarak kan transfüzyonuna ihtiyacın ve transfüzyon nedenli komplikasyonların azalmasını sağlayabilir.…”

Section: Discussionunclassified

Penetrating cardiac injuries: Review of 19 cases

Çolak¹

2017

Turk Gogus Kalp Dama

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“…84 Few other studies reported lack of efficacy and found this practice to be not cost-effective when applied to all AAA patients. 85,86 While some surgeons use IAT routinely, few others consider it in selected operations where blood loss is likely to be high, such as RAAA, complex reconstructions, thoracoabdominal aneurysms and suprarenal aneurysm surgery, or in patients with religious concerns. 87 The disadvantages of the washed red cells are that they do not contain platelets or coagulation factors.…”

Section: Fluid and Transfusion Managementmentioning

confidence: 99%