The association between intraoperative cell salvage and red blood cell transfusion in cardiac surgery – an observational study in a patient blood 
management centre

Vanessa Neef; Linda Vo; Eva Herrmann; Chris Triphaus; Leonie Judd; Andreas Winter; Kai Zacharowski; Suma Choorapoikayil; Patrick Meybohm

doi:10.5114/ait.2021.103735

eISSN: 1731-2531
ISSN: 1642-5758

Anaesthesiology Intensive Therapy

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abstract:

Original paper

The association between intraoperative cell salvage and red blood cell transfusion in cardiac surgery – an observational study in a patient blood management centre

Vanessa Neef

¹

,

Linda Vo

¹

,

Eva Herrmann

²

,

Chris Triphaus

¹

,

Leonie Judd

¹

,

Andreas Winter

¹

,

Kai Zacharowski

¹

,

Suma Choorapoikayil

¹

,

Patrick Meybohm

³

Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University Frankfurt, Germany
Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt, Germany
Department of Anesthesiology, University Hospital Wuerzburg, Wuerzburg, Germany

Anaesthesiol Intensive Ther 2021; 53, 1: 1–9

DOI: https://doi.org/10.5114/ait.2021.103735

Online publish date: 2021/02/23

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AMA

Neef V, Vo L, Herrmann E, et al. The association between intraoperative cell salvage and red blood cell transfusion in cardiac surgery – an observational study in a patient blood 
management centre. Anaesthesiology Intensive Therapy. 2021;53(1):1-9. doi:10.5114/ait.2021.103735.

APA

Neef, V., Vo, L., Herrmann, E., Triphaus, C., Judd, L.,  & Winter, A. et al. (2021). The association between intraoperative cell salvage and red blood cell transfusion in cardiac surgery – an observational study in a patient blood 
management centre. Anaesthesiology Intensive Therapy, 53(1), 1-9. https://doi.org/10.5114/ait.2021.103735

Chicago

Neef, Vanessa, Linda Vo, Eva Herrmann, Chris Triphaus, Leonie Judd, Andreas Winter,  and Kai Zacharowski et al. 2021. "The association between intraoperative cell salvage and red blood cell transfusion in cardiac surgery – an observational study in a patient blood 
management centre". Anaesthesiology Intensive Therapy 53 (1): 1-9. doi:10.5114/ait.2021.103735.

Harvard

Neef, V., Vo, L., Herrmann, E., Triphaus, C., Judd, L., Winter, A., Zacharowski, K., Choorapoikayil, S.,  and Meybohm, P. (2021). The association between intraoperative cell salvage and red blood cell transfusion in cardiac surgery – an observational study in a patient blood 
management centre. Anaesthesiology Intensive Therapy, 53(1), pp.1-9. https://doi.org/10.5114/ait.2021.103735

MLA

Neef, Vanessa et al. "The association between intraoperative cell salvage and red blood cell transfusion in cardiac surgery – an observational study in a patient blood 
management centre." Anaesthesiology Intensive Therapy, vol. 53, no. 1, 2021, pp. 1-9. doi:10.5114/ait.2021.103735.

Vancouver

Neef V, Vo L, Herrmann E, Triphaus C, Judd L, Winter A et al. The association between intraoperative cell salvage and red blood cell transfusion in cardiac surgery – an observational study in a patient blood 
management centre. Anaesthesiology Intensive Therapy. 2021;53(1):1-9. doi:10.5114/ait.2021.103735.

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Introduction
Cell salvage (CS) is an integral part of patient blood management (PBM) and aims to reduce allogeneic red blood cell (RBC) transfusion.

Material and methods
This observational study analysed patients scheduled for elective cardiac surgery requiring cardiopulmonary bypass (CPB) between November 2015 and October 2018. Patients were divided into a CS group (patients receiving CS) and a control group (no CS). Primary endpoints were the number of patients exposed to allogeneic RBC transfusions and the number of RBC units transfused per patient.

Results
A total of 704 patients undergoing cardiac surgery were analysed, of whom 338 underwent surgery with CS (CS group) and 366 were without CS (control group). Intraoperatively, 152 patients (45%) were exposed to allogeneic RBC transfusions in the CS group and 93 patients (25%) in the control group (P < 0.001). Considering the amount of intraoperative blood loss, regression analysis revealed a significant association between blood loss and increased use of RBC units in patients of the control compared to the CS group (1000 mL: 1.0 vs. 0.6 RBC units; 2000 mL: 2.2 vs. 1.1 RBC units; 3000 mL: 3.4 vs. 1.6 RBC units). Thus, CS was significantly associated with a reduced number of allogeneic RBCs by 40% for 1000 mL, 49% for 2000 mL, and 52% for 3000 mL of blood loss compared to patients without CS.

Conclusions
Cell salvage was significantly associated with a reduced number of allogeneic RBC transfusions. It supports the beneficial effect of CS in cardiac surgical patients as an individual measure in a comprehensive PBM program.

keywords:

The association between intraoperative cell salvage and red blood cell transfusion in cardiac surgery – an observational study in a patient blood management centre

Vanessa Neef 1 , Linda Vo 1 , Eva Herrmann 2 , Chris Triphaus 1 , Leonie Judd 1 , Andreas Winter 1 , Kai Zacharowski 1 , Suma Choorapoikayil 1 , Patrick Meybohm 3

cell salvage, cardiac surgery, patient blood management, transfusion

Vanessa Neef

¹

,

Linda Vo

¹

,

Eva Herrmann

²

,

Chris Triphaus

¹

,

Leonie Judd

¹

,

Andreas Winter

¹

,

Kai Zacharowski

¹

,

Suma Choorapoikayil

¹

,

Patrick Meybohm

³