Intraoperative use of cell saver devices decreases the rate of hyperlactatemia in patients undergoing cardiac surgery

Objective: This study was aimed to elucidate the effect of the intraoperative cell saver (CS) on hyperlactatemia of patients who underwent cardiac surgery. Design: A sub-analysis of the CS was performed, which is a historial control trial of patients undergoing cardiac surgery. Setting: This was a r...

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Main Authors: Yenong Zhou, Chen Yang, Zhenxiao Jin, Bing Zhang
Format: Article
Language:English
Published: Elsevier 2023-05-01
Series:Heliyon
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405844023032061
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author Yenong Zhou
Chen Yang
Zhenxiao Jin
Bing Zhang
author_facet Yenong Zhou
Chen Yang
Zhenxiao Jin
Bing Zhang
author_sort Yenong Zhou
collection DOAJ
description Objective: This study was aimed to elucidate the effect of the intraoperative cell saver (CS) on hyperlactatemia of patients who underwent cardiac surgery. Design: A sub-analysis of the CS was performed, which is a historial control trial of patients undergoing cardiac surgery. Setting: This was a retrospective single-center and not blinded study. Participants: We examined the occurrence of hyperlactatemia retrospectively in patients of CS group (n = 78) who were included in prospective trial and received valvular surgery, where CS was used during the procedure. Patients subjected to valvular surgery before February 2021 were adopted in control group (n = 79). Interventions: Arterial blood was sampled (1) before cardiopulmonary bypass, (2) during bypass (3) immediately after bypass, (4) on ICU admission and (5) every 4 h up to 24 h postoperatively. Measurements and main results: A lower incidence of hyperlactatemia (32.1% vs. 57.0%; P = 0.001) was observed in patients from the CS group. Furthermore, the blood lactate concentration was higher in control group than in CS group during CPB, post CPB, on ICU admission and lasted until 20 h after the operation. Multivariable analysis revealed that intraoperative use of CS was expected to be a protective factor against hyperlactatemia in this study (OR = 0.31, 95% CI 0.15–0.63, P = 0.001). Conclusion: Intraoperative use of a CS device was associated with a lower incidence of hyperlactatemia. Whether such device use is valuable to limiting hyperlactatemia in cardiac patients after surgery requires further evaluation in larger prospective studies.
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spelling doaj.art-81ab56033b774d99bc038f8a37abf0e02023-05-31T04:46:16ZengElsevierHeliyon2405-84402023-05-0195e15999Intraoperative use of cell saver devices decreases the rate of hyperlactatemia in patients undergoing cardiac surgeryYenong Zhou0Chen Yang1Zhenxiao Jin2Bing Zhang3Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, ChinaDepartment of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, ChinaDepartment of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, ChinaCorresponding author. Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, West Changle Road 127, Xi'an, 710000, China.; Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, ChinaObjective: This study was aimed to elucidate the effect of the intraoperative cell saver (CS) on hyperlactatemia of patients who underwent cardiac surgery. Design: A sub-analysis of the CS was performed, which is a historial control trial of patients undergoing cardiac surgery. Setting: This was a retrospective single-center and not blinded study. Participants: We examined the occurrence of hyperlactatemia retrospectively in patients of CS group (n = 78) who were included in prospective trial and received valvular surgery, where CS was used during the procedure. Patients subjected to valvular surgery before February 2021 were adopted in control group (n = 79). Interventions: Arterial blood was sampled (1) before cardiopulmonary bypass, (2) during bypass (3) immediately after bypass, (4) on ICU admission and (5) every 4 h up to 24 h postoperatively. Measurements and main results: A lower incidence of hyperlactatemia (32.1% vs. 57.0%; P = 0.001) was observed in patients from the CS group. Furthermore, the blood lactate concentration was higher in control group than in CS group during CPB, post CPB, on ICU admission and lasted until 20 h after the operation. Multivariable analysis revealed that intraoperative use of CS was expected to be a protective factor against hyperlactatemia in this study (OR = 0.31, 95% CI 0.15–0.63, P = 0.001). Conclusion: Intraoperative use of a CS device was associated with a lower incidence of hyperlactatemia. Whether such device use is valuable to limiting hyperlactatemia in cardiac patients after surgery requires further evaluation in larger prospective studies.http://www.sciencedirect.com/science/article/pii/S2405844023032061Cardiopulmonary bypassHyperlactatemiaCell saverPrognosis
spellingShingle Yenong Zhou
Chen Yang
Zhenxiao Jin
Bing Zhang
Intraoperative use of cell saver devices decreases the rate of hyperlactatemia in patients undergoing cardiac surgery
Heliyon
Cardiopulmonary bypass
Hyperlactatemia
Cell saver
Prognosis
title Intraoperative use of cell saver devices decreases the rate of hyperlactatemia in patients undergoing cardiac surgery
title_full Intraoperative use of cell saver devices decreases the rate of hyperlactatemia in patients undergoing cardiac surgery
title_fullStr Intraoperative use of cell saver devices decreases the rate of hyperlactatemia in patients undergoing cardiac surgery
title_full_unstemmed Intraoperative use of cell saver devices decreases the rate of hyperlactatemia in patients undergoing cardiac surgery
title_short Intraoperative use of cell saver devices decreases the rate of hyperlactatemia in patients undergoing cardiac surgery
title_sort intraoperative use of cell saver devices decreases the rate of hyperlactatemia in patients undergoing cardiac surgery
topic Cardiopulmonary bypass
Hyperlactatemia
Cell saver
Prognosis
url http://www.sciencedirect.com/science/article/pii/S2405844023032061
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