HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Simon M. Allen Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Murphy, G. J. Articles by Dalrymple-Hay, M. J. R. Search for Related Content PubMed PubMed Citation Articles by Murphy, G. J. Articles by Dalrymple-Hay, M. J. R. Related Collections Extracorporeal circulation

Ann Thorac Surg 2004;77:1553-1559
© 2004 The Society of Thoracic Surgeons

---

Original articles: cardiovascular

Safety and efficacy of perioperative cell salvage and autotransfusion after coronary artery bypass grafting: a randomized trial

^a Department of Cardiothoracic Surgery, Derriford Hospital, Plymouth, United Kingdom

Accepted for publication October 14, 2003.

^* Address reprint requests to Dr Murphy, Department of Cardiothoracic Surgery, Bristol Heart Institute, Bristol Royal Infirmary, Bristol BS2 8HW, UK
e-mail: gavinmurphy{at}hotmail.com

Presented at the Fiftieth Annual Meeting of the Southern Thoracic Surgical Association, Bonita Springs, FL, Nov 13–15, 2003.

BACKGROUND: The aim of this study was to ascertain whether cell salvage and autotransfusion after first time elective coronary artery bypass grafting is associated with a significant reduction in the use of homologous blood, a clinically significant derangement of postoperative clotting profiles, or an increased risk of postoperative bleeding.

METHODS: Patients were randomized to autotransfusion (n = 98) receiving autotransfused washed blood from intraoperative cell salvage and postoperative mediastinal fluid cell salvage after coronary artery bypass surgery or control (n = 102) receiving stored homologous blood only after coronary artery bypass surgery.

RESULTS: There was no statistical difference between the groups in terms of demographics, comorbidity, risk stratification, or operative details. Mean volume of blood autotransfused was 367 ± 113 mL. Patients in the autotransfusion group were significantly less likely to receive a homologous blood transfusion compared with controls (odds ratio 0.40, 95% confidence interval [CI] 0.22–0.71) and received significantly fewer units of blood per patient compared with controls (0.43 ± 1.5 vs 0.90 ± 2.0 U, p = 0.02). There was no difference between the groups in terms of postoperative blood loss, fluid requirements, blood product requirements, or in the incidence of adverse clinical events (p = NS ²). Autotransfusion did not produce any significant derangement of thromboelastograph values or laboratory measures of clotting pathway function (prothrombin time, activated partial thromboplastin time, fibrinogen, and fibrinogen D-dimer levels) when compared with the effect of homologous blood transfusion (p = NS, repeated measures analysis of variance [MANOVA]).

CONCLUSIONS: Autotransfusion is a safe and effective method of reducing the use of homologous bank blood after routine first time coronary artery bypass grafting.

This article has been cited by other articles:

				H. D. Golab, T. V. Scohy, P. L. de Jong, J. J.M. Takkenberg, and A. J.J.C. Bogers Intraoperative cell salvage in infants undergoing elective cardiac surgery: a prospective trial. Eur. J. Cardiothorac. Surg., August 1, 2008; 34(2): 354 - 359. [Abstract] [Full Text] [PDF]

				C. G. Koch, L. Li, D. I. Sessler, P. Figueroa, G. A. Hoeltge, T. Mihaljevic, and E. H. Blackstone Duration of Red-Cell Storage and Complications after Cardiac Surgery N. Engl. J. Med., March 20, 2008; 358(12): 1229 - 1239. [Abstract] [Full Text] [PDF]

				Z. I. Khalpey, R. B. Ganim, and J. D. Rawn Postoperative Care of Cardiac Surgery Patients Card. Surg. Adult, January 1, 2008; 3(2008): 465 - 486. [Full Text]

				E. Sirvinskas, A. Veikutiene, R. Benetis, P. Grybauskas, J. Andrejaitiene, V. Veikutis, and J. Surkus Influence of early re-infusion of autologous shed mediastinal blood on clinical outcome after cardiac surgery Perfusion, September 1, 2007; 22(5): 345 - 352. [Abstract] [PDF]

				G.J. Murphy, C.S. Rogers, W.B. Lansdowne, I. Channon, H. Alwair, A. Cohen, M. Caputo, and G.D. Angelini Safety, efficacy, and cost of intraoperative cell salvage and autotransfusion after off-pump coronary artery bypass surgery: A randomized trial J. Thorac. Cardiovasc. Surg., July 1, 2005; 130(1): 20 - 28. [Abstract] [Full Text] [PDF]