title: Cell salvage during coronary artery bypass surgery and allogenic blood exposure.
abstract: OBJECTIVE
  Our primary aim was to assess the impact of intraoperative cell saver usage on patient exposure to allogenic blood transfusion during elective coronary artery bypass. The secondary endpoint was the impact of cell savage on the units of blood and blood products transfused perioperatively.
  
  
  METHODS
  A prospective observational cohort study with a historical cohort as a control group was performed in a single tertiary care center. One hundred and twenty-four patients undergoing primary on-pump coronary artery bypass grafting were included. Intraoperative cell salvage was performed in 60 patients (study group) but not in the control group (n = 64). Transfusion data, intensive care unit stay, hospital stay, and postoperative complications were evaluated in the cell saver and control groups.
  
  
  RESULTS
  The number of patients exposed to allogenic red blood cell transfusion was significantly less in the study group (55% vs. 82.8%; p = 0.001) and the units per patient was also less in the study group (1.10 ± 1.7 vs. 2.25 ± 2.289 units; p = 0.002). However, there was no significant difference in terms of units of purified plasma fraction, platelets, or cryoprecipitate transfused. Intensive care unit stay, total hospital stay, number of reexplorations, complications, readmissions, and 28-day mortality were similar in both groups.
  
  
  CONCLUSIONS
  Intraoperative cell salvage with a cell saver in patients undergoing primary elective coronary artery bypass decreases the proportion of patients exposed to allogenic red cell transfusions and the number of units of red blood cells transfused.
authors.affiliation: Department of Anesthesia, Royal Hospital, Muscat, Oman.
authors.forename: Said
authors.initials: S
authors.lastname: Al-Mandhari
authors.affiliation: Department of Anesthesia, Royal Hospital, Muscat, Oman madanmaddali@hotmail.com.
authors.forename: Madan Mohan
authors.initials: MM
authors.lastname: Maddali
authors.affiliation: Department of Anesthesia, Royal Hospital, Muscat, Oman.
authors.forename: Maher Jaffer
authors.initials: MJ
authors.lastname: Al-Bahrani
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000401:mortality / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000401:mortality; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D017558:Elective Surgical Procedures; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009850:Oman; D057725:Operative Blood Salvage / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D010359:Patient Readmission; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Blood loss; Blood preservation; Blood transfusion; Coronary artery bypass; Erythrocyte transfusion; Platelet transfusion; surgical