title: Does use of cell saver decrease the inflammatory response in cardiac surgery?
abstract: BACKGROUND
  The role of a cell-saver device in the inflammatory response to cardiac surgery has not been well documented. We hypothesized that the use of a cell saver may reduce proinflammatory cytokine concentrations in patients undergoing cardiac surgery.
  
  
  METHODS
  57 patients presenting for first-time nonemergency cardiac surgery were prospectively randomized to control or cell salvage groups. Blood samples for inflammatory marker assays were collected from the arterial line on induction of anesthesia, at the end of cardiopulmonary bypass, 1 h after surgery, and 24 h after surgery. Plasma proinflammatory cytokines were analyzed using a sandwich solid-phase enzyme-linked immunosorbent assay.
  
  
  RESULTS
  The highest cytokine levels were observed 1 h after surgery. When comparing serum interleukin levels in both patient groups during the different perioperative periods, we found a higher interleukin-8 concentration 24 h after the procedure, and higher concentrations of the p40 subunit of interleukin-12 at 1 h and 24 h postoperatively. The concentrations of interleukin-6 and p40 were greater in blood stored by the cardiotomy suction system than in blood processed by the cell saver (p = 0.01 in both cases). The interleukin-8 concentration was higher in the blood processed by the cell saver (p = 0.03). No significant differences were observed in interleukin-1 and interferon gamma levels in blood from both systems. Clinical outcomes were similar in both groups.
  
  
  CONCLUSIONS
  Our results suggest that cell salvage in low-risk patients undergoing their first elective cardiac procedure does not decrease the inflammatory response after surgery.
authors: Department of Anesthesiology, Hospital Universitario La Princesa, Madrid, Spain.
authors: Maria A
authors: MA
authors: Prieto
authors: Sara
authors: S
authors: Guash
authors: Jose C
authors: JC
authors: Mendez
authors: Cecilia
authors: C
authors: Munoz
authors: Antonio
authors: A
authors: Planas
authors: Guillermo
authors: G
authors: Reyes
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001804:Blood Transfusion, Autologous / Q000009:adverse effects; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D016009:Chi-Square Distribution; D017558:Elective Surgical Procedures; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000276:immunology / Q000517:prevention & control*; D018836:Inflammation Mediators / Q000097:blood*; D007371:Interferon-gamma / Q000097:blood; D053762:Interleukin-12 Subunit p40 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D057725:Operative Blood Salvage / Q000009:adverse effects; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C508606:CXCL8 protein, human; C573415:IFNG protein, human; C500879:IL12B protein, human; C508600:IL6 protein, human; D018836:Inflammation Mediators; D053762:Interleukin-12 Subunit p40; D015850:Interleukin-6; D016209:Interleukin-8; D007371:Interferon-gamma