title: Is a cell saver necessary in off-pump coronary artery bypass surgery?
abstract: BACKGROUND
  Off-pump coronary artery bypass surgery should have a significantly lower risk of postoperated bleeding than on-pump surgery. However, the use of a cell saver has been considered necessary, with significant additional cost incurred. Can we consider performing off-pump coronary artery bypass surgery without a cell saver?
  
  
  METHODS
  A prospective observational study was performed in 68 consecutive patients operated on for 2- or 3-vessel coronary lesions by the off-pump technique.
  
  
  RESULTS
  The mean number of distal anastomoses was 2.7 ± 0.7. Both internal thoracic arteries were used in 45 patients, and sequential revascularization was performed in 27, with 140 (77.8%) arterial grafts. Cell savers were used in 21 (30.9%) patients. In these 21 patients, the mean volume retransfused after treatment was 315 ± 177 mL. Postoperatively, 11 (16.2%) patients were transfused with packed red blood cells, with a mean volume of 636 ± 234 mL per patient. The 2 factors identified as associated with a higher risk of autotransfusion were female sex and a lower preoperative hemoglobin.
  
  
  CONCLUSIONS
  The use of a cell saver in off-pump surgery is useless in most cases. Careful surgical hemostasis is essential to limit hypovolemia.
authors.affiliation: Cardiovascular and Thoracic Surgery Department, Hue Central Hospital, Vietnam. luongtannguyen@gmail.com
authors.forename: Nguyen Luong
authors.initials: NL
authors.lastname: Tan
authors.forename: Hervé
authors.initials: H
authors.lastname: Corbineau
authors.forename: Bui Duc
authors.initials: BD
authors.lastname: Phu
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Verhoye
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous; D016009:Chi-Square Distribution; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000097:blood / Q000601:surgery*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D057725:Operative Blood Salvage; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006454:Hemoglobins