Discriminatory power of the intraoperative cell salvage use in the prediction of platelet and plasma transfusion in patients undergoing cardiac surgery

Al-Khabori, Murtadha; Al-Riyami, Arwa Z.; Baskaran, Balan; Siddiqi, Mohammad Salman; Al-Sabti, Hilal

doi:10.1016/j.transci.2015.03.019

Cited by 12 publications

(3 citation statements)

References 24 publications

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“…118 Moreover, large volumes of cell-salvaged blood may lead to a relative loss of plasma and may result in impaired coagulation. 145 Therefore, it may be concluded that the balance between a positive effect of cell salvage on transfusion requirements and a reduction of negative systemic effects (versus the inherent loss of plasma, platelets and leucocytes) depends on the quantity of the salvaged blood.…”

Section: Cell Salvagementioning

confidence: 99%

2017 EACTS/EACTA Guidelines on patient blood management for adult cardiac surgery

Boer¹,

Meesters²,

Milojevic³

et al. 2018

Journal of Cardiothoracic and Vascular Anesthesia

309

180

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Section: Cell Salvagementioning

confidence: 99%

2017 EACTS/EACTA Guidelines on patient blood management for adult cardiac surgery

Boer¹,

Meesters²,

Milojevic³

et al. 2018

Journal of Cardiothoracic and Vascular Anesthesia

309

180

View full text Add to dashboard Cite

“…Besides, the ultrafiltration may cause hemoconcentration and then increase the concentration of coagulation factors. 4 Cell saver will filter out the coagulation factors and retain only RBC, 7 which will have a certain effect on the use of FFP. 8 Consistent with the decrease in FFP volume, postoperative drainage volume also decreased significantly.…”

Section: Discussionmentioning

confidence: 99%

The impact of comprehensive blood conservation program on major complications after total aortic arch replacement

et al. 2022

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Introduction Patients undergoing total aortic arch replacement (TAAR) usually require blood products perioperatively. This cohort study aimed to investigate the impact of a comprehensive blood conservation program on the major complications in these patients. Methods Patients with traditional or comprehensive blood management intraoperatively from January 2017 to December 2018 were included. We compared the rates of major complications (cerebral vascular accident, acute kidney injury, or mortality) between the two groups after propensity score matching (PSM). The association between blood management and outcomes was assessed by logistic regression. Restricted cubic splines (RCS) were built to evaluate the impact of fresh frozen plasma (FFP) on complications. Patients were stratified by the ratio of FFP/RBC (red blood cell) to investigate the effect of the ratio on complications. Results After 1:1 PSM, 200 patients were selected. 35% (35/100) of patients suffered major complications in the traditional group, while it decreased to 22% (22/100) in the comprehensive management group (OR = 0.524, p = 0.043). Multivariable logistic regression showed that FFP was a risk factor (OR = 1.186, p = 0.014). RCS results indicated that with the increase of FFP, the risk of complications gradually increases. The cut-off value was 402 mL. Patients in the group of ratio = 0 ∼ 0.5 had a higher chance than those without transfusion (OR = 7.487, p < 0.001). Conclusions Comprehensive blood conservation program in patients undergoing TAAR is safe and can reduce the incidence of major complications, which are associated with FFP volume and the ratio of FFP/RBC.

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“…Unwashed salvaged blood from postoperative surgical drains includes an elevated amount of inflammatory mediators, fibrin split products, interleukins, fat emboli, and complement factors, which could lead to inflammatory complications [57]. Patients receiving postoperative cell salvage blood had a 15.6% lower risk of allogeneic blood exposure during cardiac surgery [58], but it may compromise coagulation when large amounts of cell salvaged blood (> 1000 ml) are retransfused [59]. Thus, it is recommended to process the mediastinal shed blood by centrifugation and reinfuse it (Class IIb, Level of Evidence B) [16].…”

Section: Postoperative Strategiesmentioning

confidence: 99%

Cardiac Surgery and Blood-Saving Techniques: An Update

Yousuf¹,

Samad²,

Ahmed³

et al. 2022

Cureus

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Cardiac surgery is typically attributed with a significant risk of intraoperative blood loss and allogeneic blood transfusions. Intraoperative blood loss, allogenic blood transfusions, high dose anticoagulation requirement, and interactions with cardiopulmonary bypass (CPB) have all been linked to cardiac surgeries. To reduce unnecessary transfusions and their negative effects, it is recommended to follow evidence-based multidisciplinary strategies, which are collectively termed patient blood management (PBM). This review highlights the most recent blood conservation strategies in adult cardiac surgery, which can be employed pre-operatively, intra-operatively, and postoperatively, to enhance red cell mass and attenuate the utilization of packed red blood cells (PRBCs) and other blood products.

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Discriminatory power of the intraoperative cell salvage use in the prediction of platelet and plasma transfusion in patients undergoing cardiac surgery

Cited by 12 publications

References 24 publications

2017 EACTS/EACTA Guidelines on patient blood management for adult cardiac surgery

2017 EACTS/EACTA Guidelines on patient blood management for adult cardiac surgery

The impact of comprehensive blood conservation program on major complications after total aortic arch replacement

Cardiac Surgery and Blood-Saving Techniques: An Update

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