Shed-blood-separation and cell-saver: an integral Part of MiECC? Shed-blood-separation and its influence on the perioperative inflammatory response during coronary revascularization with minimal invasive extracorporeal circulation systems – a randomized controlled trial

Bauer, Adrian; Hausmann, Harald; Schaarschmidt, Jan; Scharpenberg, Martin; Troitzsch, D; Johansen, Peter; Nygaard, Hans; Eberle, Thomas S.; Hasenkam, J. Michael

doi:10.1177/0267659117728195

Cited by 23 publications

(24 citation statements)

References 28 publications

(31 reference statements)

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“…As Fig. illustrates, the earlier studies show a beneficial effect while the recent studies show no effect with a statistically significant difference in the effect size between the two groups. This explains the observed heterogeneity.…”

Section: Discussionmentioning

confidence: 77%

“…reported mean transfusion volumes and did not report the proportions of patients who received blood transfusion in the CS and non‐CS groups; therefore, it was not included. Fifteen studies were included in the final analysis; of which, all reported RBC transfusion rate, and eleven reported platelet and FFP transfusion rates.…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen studies were identified (Table ); all were included for the RBC transfusion outcome, and eleven were included for the platelet and FFP transfusion outcomes. All trials had at least two arms; two studies had three arms, and only one study used four arms (if CS was used in more than one arm, the results were combined for the CS arms).…”

Section: Resultsmentioning

confidence: 99%

“…Except for two , the included studies were not double blinded. In seven studies , the analysis was intention to treat; however, it was not clear in six studies .…”

Section: Resultsmentioning

confidence: 99%

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Impact of cell saver during cardiac surgery on blood transfusion requirements: a systematic review and meta‐analysis

et al. 2019

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Objective We performed a systematic review and meta‐analysis of randomized clinical trials on adult patients undergoing cardiac surgery and compared the rates of red blood cell (RBC), platelet and fresh frozen plasma (FFP) transfusion between the cell saver (CS) and the standard of care groups. Methods MEDLINE ®, The Cochrane Central Register of Controlled Trials (CENTRAL), American Society of Hematology (ASH) and bibliographies of relevant studies were searched. We used random‐effect model. Results Our search strategy returned 624 citations, of which 15 studies were selected. The use of CS did not decrease the rate of RBC transfusion (odds ratio [OR]: 0·69; 95% CI: 0·48–1·00), albeit with a substantial heterogeneity (I2 = 60%). The year of publication explained most of the heterogeneity (P for subgroup effect <0·001). Although the rate of platelet transfusion was lower in the CS group, the difference was not statistically significant (OR: 0·83; 95% CI: 0·57–1·2; I2 = 0%). The rate of FFP transfusion was numerically higher in the CS group; however, this difference did not reach statistical significance (OR: 1·26; 95% CI: 0·82–1·94; I2 = 15%). Only two studies scored five on the Jadad score. There was no indication of a publication bias using the funnel plot and Egger test (P = 0·34, 0·87, and 0·62 for RBC, platelet and FFP, respectively). Conclusion The use of CS during cardiac surgery does not have an impact on the rates of RBC, platelet and FFP transfusion; however, this should be interpreted in the light of the study limitations.

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Section: Discussionmentioning

confidence: 77%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Except for two , the included studies were not double blinded. In seven studies , the analysis was intention to treat; however, it was not clear in six studies .…”

Section: Resultsmentioning

confidence: 99%

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Impact of cell saver during cardiac surgery on blood transfusion requirements: a systematic review and meta‐analysis

et al. 2019

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“…[30] Other equipment for immune response in cardiac surgery are minimal invasive extracorporeal circulation and the cell-saver both of which may have favorable effects on the immune response, reducing the systemic cytokine load. [31] All these measures affecting the immune response and inflammation may be reasonable and should be kept in mind for COVID-19 patients during cardiac surgery.…”

Section: And Further Potential Effects Of Cardiac Surgerymentioning

confidence: 99%

Perioperative planning for cardiovascular operations in the COVID-19 pandemic

Mavioğlu¹

2020

Turk Gogus Kalp Dama

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ÖZKoronavirüs hastalığı-2019 (COVID-19) tüm dünyada sağlık çalışanlarını alarm durumuna geçiren ciddi bir sağlık sorunudur. Pandeminin beraberinde getirmiş olduğu ve sağlık sistemini ilgilendiren ele alınması gereken iki önemli konu mevcuttur. Birincisi; pandeminin yayılma hızına yetişme sıkıntısı çekebilecek olan sağlık sisteminin yükünü azaltabilmek açısından elektif birçok işlemin/cerrahinin ertelenmesi gerekliliğidir. Bu nedenle, cerrahi gereken kardiyovasküler hastalıkların önceliğinin ve ertelenebilirliğinin belirlenmesi için "Öncelik Düzeyi" olarak adlandırdığımız bir algoritma geliştirilmesini amaçladık. İkinci olarak ise; kardiyovasküler cerrahi yapılması gereken acil ve öncelikli hastalarda cerrahinin ve sonrasında yoğun bakım ünitesinde takibinin, enfeksiyon koruma tedbirlerinin sağlandığı bir ortamda yapılması gerekliliğidir. Bu yazıda, hasta güvenliğinin sağlanabilmesi ve cerrahi ekibin maksimum seviyede korunabilmesi için uygulanabilecek olan gerekli tedbirler sunuldu. ABSTRACTCoronavirus disease-2019 (COVID-19) is a serious health concern which alert all healthcare professionals worldwide. There are two main issues caused by this pandemic regarding for the healthcare system. First, it is a necessity to postpone many elective procedures/surgeries to reduce the burden of the healthcare system which may be confronted with strain by the increased speed of transmission. Therefore, we aimed to develop an algorithm called as Level of Priority to identify the priority and deferrability of cardiovascular diseases requiring surgery. Second, it is essential to perform surgery and intensive care unit follow-up in a setting where the infection prevention measures are followed for primary patients requiring emergency cardiovascular surgery. In this article, we present necessary precautions to be exercised to provide the patient safety and the highest level of protection for the surgical team.

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Effects of interventions targeting the systemic inflammatory response to cardiac surgery on clinical outcomes in adults

Abbasciano,

Tomassini,

Roman

et al. 2023

Cochrane Database of Systematic Reviews

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Shed-blood-separation and cell-saver: an integral Part of MiECC? Shed-blood-separation and its influence on the perioperative inflammatory response during coronary revascularization with minimal invasive extracorporeal circulation systems – a randomized controlled trial

Abstract: The use of a cell-saver and the processing of shed blood as an integral part of MiECC significantly reduces the systemic cytokine load. We, therefore, recommend the integration of cell-saving devices in MiECC to reduce the perioperative inflammatory response.

Cited by 23 publications

References 28 publications

Impact of cell saver during cardiac surgery on blood transfusion requirements: a systematic review and meta‐analysis

Impact of cell saver during cardiac surgery on blood transfusion requirements: a systematic review and meta‐analysis

Perioperative planning for cardiovascular operations in the COVID-19 pandemic

Effects of interventions targeting the systemic inflammatory response to cardiac surgery on clinical outcomes in adults

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