Use of Cell Saver in Elective Coronary Bypass Surgery: What Do We Risk When Saving Blood?

TL;DR

This study finds that using Cell Saver during heart surgery reduces blood transfusions but increases bleeding and hospital stays.

Contribution

The study provides new clinical evidence on the risks and benefits of Cell Saver in elective coronary bypass surgery.

Findings

Cell Saver use was linked to higher postoperative drainage and bleeding.

Patients using Cell Saver had longer hospital stays and lower postoperative albumin levels.

The technique reduces allogeneic transfusion needs but increases short-term complications.

Abstract

Background/Objectives: Allogeneic transfusion is a commonly used method to replace blood and blood elements lost during cardiac surgery, but it also has quite undesirable effects. The use of Cell Saver is now almost routinely recommended. The aim of this study is to investigate the clinical and laboratory outcomes of the use of Cell Saver in elective CABG. Methods: Patients who had undergone elective CABG between January 2022 and October 2024 were retrospectively analyzed, and 344 patients were included in the study. Patients were divided into two groups: Cell Saver used (CS, n = 110) and not used (NCS, n = 234). The groups were compared in terms of pre- and postoperative clinical and laboratory outcomes. Results: The mean age of the cases included in the study was 63.65 ± 9.05 years (340 patients, range 36–87). The mean amount of drainage in the first 6 h postoperatively was 298.18 ± 155.81 mL in the NCS group and 388.64 ± 173.62 mL in the CS group (p < 0.001). In the first 24 h, it was 703.22 ± 320.39 mL in the NCS group and 827.73 ± 344.69 mL in the CS group (p = 0.001). Prolonged drainage was more frequent in the CS group (p = 0.004) and the length of hospital stay was longer (p = 0.014). The postoperative albumin level was lower in the CS group (p = 0.003). Conclusions: Although the use of Cell Saver reduces the need for allogeneic transfusions, it leads to increased bleeding in the initial period, prolonged drainage, and thus a longer hospital stay. In elective procedures, blood management should be evaluated and optimized using all methods.

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