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Impact of cell saver during cardiac surgery on blood transfusion requirements: a systematic review and meta‐analysis
Author(s) -
Al Khabori Murtadha,
Al Riyami Arwa,
Siddiqi Mohammad Salman,
Sarfaraz Ziyab Khan,
Ziadinov Edem,
Al Sabti Hilal
Publication year - 2019
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/vox.12824
Subject(s) - medicine , funnel plot , jadad scale , meta analysis , publication bias , fresh frozen plasma , platelet transfusion , odds ratio , subgroup analysis , randomized controlled trial , blood transfusion , cardiac surgery , platelet , hematocrit , surgery , cochrane library
Objective We performed a systematic review and meta‐analysis of randomized clinical trials on adult patients undergoing cardiac surgery and compared the rates of red blood cell (RBC), platelet and fresh frozen plasma (FFP) transfusion between the cell saver (CS) and the standard of care groups. Methods MEDLINE ®, The Cochrane Central Register of Controlled Trials (CENTRAL), American Society of Hematology (ASH) and bibliographies of relevant studies were searched. We used random‐effect model. Results Our search strategy returned 624 citations, of which 15 studies were selected. The use of CS did not decrease the rate of RBC transfusion (odds ratio [OR]: 0·69; 95% CI: 0·48–1·00), albeit with a substantial heterogeneity ( I 2 = 60%). The year of publication explained most of the heterogeneity ( P for subgroup effect <0·001). Although the rate of platelet transfusion was lower in the CS group, the difference was not statistically significant (OR: 0·83; 95% CI: 0·57–1·2; I 2 = 0%). The rate of FFP transfusion was numerically higher in the CS group; however, this difference did not reach statistical significance (OR: 1·26; 95% CI: 0·82–1·94; I 2 = 15%). Only two studies scored five on the Jadad score. There was no indication of a publication bias using the funnel plot and Egger test ( P = 0·34, 0·87, and 0·62 for RBC, platelet and FFP, respectively). Conclusion The use of CS during cardiac surgery does not have an impact on the rates of RBC, platelet and FFP transfusion; however, this should be interpreted in the light of the study limitations.