TY - JOUR
T1 - Additional filtering of blood from a cell salvage device is not likely to show important additional benefits in outcome in cardiac surgery
AU - de Vries, Adrianus J.
AU - Vermeijden, Wytze J.
AU - van Pelt, L. Joost
AU - van den Heuvel, Edwin R.
AU - van Oeveren, Willem
PY - 2019/3
Y1 - 2019/3
N2 - BACKGROUND: Several authors and manufacturers of cell salvage devices recommend additional filtering of processed blood before transfusion. There is no evidence to support this practice. Therefore, we compared the clinical outcome and biochemical effects of cell salvage with or without additional filtering. STUDY DESIGN AND METHODS: The patients, scheduled for coronary artery bypass grafting, valve replacement, or combined procedures were part of our randomized multicenter factorial study of cell salvage and filter use on transfusion requirements (ISRCTN 58333401). They were randomized to intraoperative cell salvage or cell salvage plus additional WBC depletion filter. We compared the occurrence of major adverse events (combined death/stroke/myocardial infarction) as primary outcome and minor adverse events (renal function disturbances, infections, delirium), ventilation time, and length of stay in the intensive care unit and hospital. We also measured biochemical markers of organ injury and inflammation. RESULTS: One hundred eighty-nine patients had cell salvage, and 175 patients had cell salvage plus filter and completed the study. Demographic data, surgical procedures, and amount of salvaged blood were not different between the groups. There was no difference in the primary outcome with a risk of 6.3% (95% confidence interval [CI], 3.34–11.25) in the cell salvage plus filter group versus 5.8% (95% CI, 3.09–10.45) in the cell salvage group, a relative risk of 1.08 (95% CI, 0.48– 2.43]. There were no differences in minor adverse events and biochemical markers between the groups. CONCLUSION: The routine use of an additional filter for transfusion of salvaged blood is unlikely to show important additional benefits.
AB - BACKGROUND: Several authors and manufacturers of cell salvage devices recommend additional filtering of processed blood before transfusion. There is no evidence to support this practice. Therefore, we compared the clinical outcome and biochemical effects of cell salvage with or without additional filtering. STUDY DESIGN AND METHODS: The patients, scheduled for coronary artery bypass grafting, valve replacement, or combined procedures were part of our randomized multicenter factorial study of cell salvage and filter use on transfusion requirements (ISRCTN 58333401). They were randomized to intraoperative cell salvage or cell salvage plus additional WBC depletion filter. We compared the occurrence of major adverse events (combined death/stroke/myocardial infarction) as primary outcome and minor adverse events (renal function disturbances, infections, delirium), ventilation time, and length of stay in the intensive care unit and hospital. We also measured biochemical markers of organ injury and inflammation. RESULTS: One hundred eighty-nine patients had cell salvage, and 175 patients had cell salvage plus filter and completed the study. Demographic data, surgical procedures, and amount of salvaged blood were not different between the groups. There was no difference in the primary outcome with a risk of 6.3% (95% confidence interval [CI], 3.34–11.25) in the cell salvage plus filter group versus 5.8% (95% CI, 3.09–10.45) in the cell salvage group, a relative risk of 1.08 (95% CI, 0.48– 2.43]. There were no differences in minor adverse events and biochemical markers between the groups. CONCLUSION: The routine use of an additional filter for transfusion of salvaged blood is unlikely to show important additional benefits.
KW - Aged
KW - Blood Transfusion/methods
KW - Cardiac Surgical Procedures/methods
KW - Coronary Artery Bypass/methods
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/surgery
KW - Stroke/surgery
KW - Treatment Outcome
UR - http://www.scopus.com/inward/record.url?scp=85059535126&partnerID=8YFLogxK
U2 - 10.1111/trf.15130
DO - 10.1111/trf.15130
M3 - Article
C2 - 30610759
AN - SCOPUS:85059535126
SN - 0041-1132
VL - 59
SP - 989
EP - 994
JO - Transfusion
JF - Transfusion
IS - 3
ER -