title: Dialyzer-based cell salvage system: a superior alternative to conventional cell salvage in off-pump coronary artery bypass grafting.
abstract: Our goal was to test the hypothesis that the use of a dialyzer-based cell salvage system during off-pump coronary artery bypass grafting (OPCABG) reduces requirements for homologous blood transfusions (HBT) and improves postoperative haemtochemical parameters.
  
  
  
  Data were prospectively collected for 222 patients who had OPCABG using 3 different cell salvage techniques: (1) dialyzer-based cell salvage (DBCS) ( n  = 75), (2) conventional cell salvage (CCS) ( n  = 73) and (3) without cell salvage (WCS) ( n  = 74). Salvaged blood was transfused at the end of the operation. The primary outcome of the study was the amount of homologous blood transfused. Secondary outcomes were changes in haemtochemical parameters, postoperative bleeding, need for non-invasive ventilation (NIV), postoperative complications, renal dysfunction, clotting derangement, duration of intensive care unit (ICU) and hospital stay and mortality rates.
  
  
  
  There were no deaths. In patients with >1000 ml blood loss, there was a significant reduction in HBT in the DBCS group (300 ± 161 ml) compared with the WCS group (550 ± 85 ml) ( P  <   0.0001). Postoperative changes in haemtochemical parameters were significantly fewer in the DBCS group compared with the other 2 groups. The incidence of NIV ( P  =   0.002), renal dysfunction ( P  =   0.009) and postoperative complications ( P  =   0.003) was least in the DBCS group and highest in the WCS group. Mean ICU stays were comparable ( P  =   0.208); however, the mean hospital stay was significantly shorter in the DBCS group (6.08 ± 3.12 days) compared with the WCS group (7.54 ± 4.46 days) ( P  =   0.022). There was no significant increase in coagulopathy in any group as suggested by comparable chest tube drainage ( P  =   0.285) and comparable prothrombin time.
  
  
  
  The use of the DBCS system in OPCABG resulted in a significant reduction in HBT, improvement in postoperative levels of haemoglobin, platelets and albumin and reduction in complications without increased risk of coagulopathy.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (Affiliated to BJ Medical College, Ahmedabad), Ahmedabad, Gujarat, India.
authors.forename: Amber
authors.initials: A
authors.lastname: Malhotra
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (Affiliated to BJ Medical College, Ahmedabad), Ahmedabad, Gujarat, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Garg
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (Affiliated to BJ Medical College, Ahmedabad), Ahmedabad, Gujarat, India.
authors.forename: Arvind Kumar
authors.initials: AK
authors.lastname: Bishnoi
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (Affiliated to BJ Medical College, Ahmedabad), Ahmedabad, Gujarat, India.
authors.forename: Pranav
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (Affiliated to BJ Medical College, Ahmedabad), Ahmedabad, Gujarat, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Wadhawa
authors.affiliation: Department of Research, U.N. Mehta Institute of Cardiology and Research Center (Affiliated to BJ Medical College, Ahmedabad), Ahmedabad, Gujarat, India.
authors.forename: Komal
authors.initials: K
authors.lastname: Shah
authors.affiliation: Department of Research, U.N. Mehta Institute of Cardiology and Research Center (Affiliated to BJ Medical College, Ahmedabad), Ahmedabad, Gujarat, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Patel
authors.affiliation: Department of Perfusion, U.N. Mehta Institute of Cardiology and Research Center (Affiliated to BJ Medical College, Ahmedabad), Ahmedabad, Gujarat, India.
authors.forename: Umesh Kumar
authors.initials: UK
authors.lastname: Ahirwar
authors.affiliation: Department of Perfusion, U.N. Mehta Institute of Cardiology and Research Center (Affiliated to BJ Medical College, Ahmedabad), Ahmedabad, Gujarat, India.
authors.forename: Dayesh
authors.initials: D
authors.lastname: Rodricks
authors.affiliation: Department of Research, U.N. Mehta Institute of Cardiology and Research Center (Affiliated to BJ Medical College, Ahmedabad), Ahmedabad, Gujarat, India.
authors.forename: Himani
authors.initials: H
authors.lastname: Pandya
mesh_terms: D000368:Aged; D001803:Blood Transfusion; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000628:therapy*; D005260:Female; D006454:Hemoglobins; D006801:Humans; D007688:Kidneys, Artificial; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000628:therapy; D011446:Prospective Studies
chemical_list: D006454:Hemoglobins
keywords: Conventional cell salvage; Dialyzer-based cell salvage system; Off-pump coronary artery bypass grafting