The impacts of using cell salvage in cardiac surgery: An integrative review
DOI:
https://doi.org/10.33448/rsd-v15i2.50641Keywords:
Cell recovery, Cardiac surgery, Blood transfusion, Postoperative complications.Abstract
The overall objective of this work is to identify the impacts of using cell salvage in cardiac surgery to reduce allogeneic blood transfusions, aiming to decrease postoperative complications and reduce costs. To this end, the following specific objectives were defined: contextualizing blood transfusion in the intra- and postoperative periods; the use of cell salvage in cardiac surgery; and identifying the main impacts of using this technology, focusing on the reduction of postoperative complications. Addressing the use of cell salvage in cardiac surgery is justified by the relevance and high complexity of cardiac surgical procedures. This technique has proven to be an effective strategy to increase patient safety and contribute to better clinical outcomes. This study consists of descriptive, qualitative research, structured from an integrative literature review, using the following keywords: cell salvage, cardiac surgery, and postoperative cardiac care, performed in the PubMed database, from 2015 to 2025. Through the collection of information throughout the research and the analysis of the data, it was possible to conclude that the use of cell salvage is associated with a reduction in the need for allogeneic blood transfusions, better maintenance of hemoglobin levels, and attenuation of the systemic inflammatory response, provided it is used appropriately. Further studies, especially in the national context, are needed for a better evaluation of its cost-benefit ratio.
References
Côté, C. L., Yip, A. M., MacLeod, J. B., O’Reilly, B., Murray, J., Ouzounian, M., Brown, C. D., Forgie, R., Pelletier, M. P., & Hassan, A. (2016). Efficacy of intraoperative cell salvage in decreasingperioperative blood transfusion rates in first-time cardiac surgery patients: A retrospective study. Canadian Journal of Surgery, 59(5), 330–336. https://doi.org/10.1503/cjs.002216
de Mello, M. A. A., Pereira-Rufino, L. da S., Dos Santos, A. A., Junior, N. A. H., Panfilio, C. E., de Souza, A. S., & Céspedes, I. C. (2025). Evaluation of Intraoperative and Postoperative Blood Cell Salvage Use in Cardiac Surgery with Cardiopulmonary Bypass. Brazilian Journal of Cardiovascular Surgery, 40(3). https://doi.org/10.21470/1678-9741-2024-0244
Engels, G. E., Van Klarenbosch, J., Gu, Y. J., Van Oeveren, W., & De Vries, A. J. (2016). Intraoperative cell salvage during cardiac surgery is associated with reduced postoperative lung injury. Interactive Cardiovascular and Thoracic Surgery, 22(3), 298–304. https://doi.org/10.1093/icvts/ivv355
Khan, J. H., Green, E. A., Chang, J., Ayala, A. M., Barkin, M. S., Reinys, E. E., Stanton, J., Stanten, R. D., Health, S., & Bates, A. (2017). Blood and Blood Product Conservation: Results of Strategies to Improve Clinical Outcomes in Open Heart Surgery Patients at a Tertiary Hospital. Em The Journal of ExtraCorporeal Technology J Extra Corpor Technol (Vol. 49).
Shen, S., Zhang, J., Wang, W., Zheng, J., & Xie, Y. (2016). Impact of intra-operative cell salvage on blood coagulation in high-bleeding-risk patients undergoing cardiac surgery with cardiopulmonary bypass: A prospective randomized and controlled trial. Journal of Translational Medicine, 14(1). https://doi.org/10.1186/s12967-016-0986-6
Son, K., Yamada, T., Tarao, K., Kitamura, Y., Okazaki, J., Sato, Y., & Isono, S. (2020). Effects of Cardiac Surgery and Salvaged Blood Transfusion on Coagulation Function Assessed by Thromboelastometry. Journal of Cardiothoracic and Vascular Anesthesia, 34(9), 2375–2382. https://doi.org/10.1053/j.jvca.2020.02.009
Stasko, A. J., Stammers, A. H., Mongero, L. B., Tesdahl, E. A., & Weinstein, S. (2017). The Influence of Intraoperative Autotransfusion on Postoperative Hematocrit after Cardiac Surgery: A Cross-Sectional Study. Em The Journal of ExtraCorporeal Technology (Vol. 49).
Tachias, F., Samara, E., Petrou, A., Karakosta, A., Siminelakis, S., Apostolakis, E., & Tzimas, P. (2022). The Effect of Cell Salvage on Bleeding and Transfusion Needs in Cardiac Surgery. Anesthesiology Research and Practice, 2022. https://doi.org/10.1155/2022/3993452
Tsukinaga, A., Yoshitani, K., Ogata, S., Mihara, T., Ito, S., Kanazawa, H., Shimokawa, A., Masuda, S., Morinaga, M., Ito, Y., Miura, S., Kawamoto, N., Inoue, Y., Fukushima, S., Matsuda, H., & Maeda, T. (2025). Intraoperative cell-salvaged versus allogeneic red blood cell transfusions in high-bleeding-risk cardiovascular surgery: Protocol for a single-center, randomized, parallel-group, noninferiority trial. PLOS ONE, 20(10 OCTOBER). https://doi.org/10.1371/journal.pone.0334397
Vieira, S. D., da Cunha Vieira Perini, F., Dalmazzo, L. F. F., Akil, F., Alves, P. R. G., Oliveira, E. A. F., Cesar, M. A., Pereira, T. C., Monteiro, C., Moraes, M. C., Buratta, K. B. L., & Moitinho, N. J. (2025). Quality control of intraoperative autologous blood salvage in cardiac surgery. Transfusion, 65(10), 1861–1868. https://doi.org/10.1111/trf.18384
Wang, H., Zheng, W., Fang, W., Meng, G., Zhang, L., Zhou, Y., Gu, E., & Liu, X. (2018). Safety, efficacy, and cost-effectiveness of intraoperative blood salvage in OPCABG with different amount of bleeding: A single-center, retrospective study. Journal of Cardiothoracic Surgery, 13(1). https://doi.org/10.1186/s13019-018-0794-6
Whittemore APRN, R., Knafl Elizabeth Gray Distinguished Professor, K. N., & Knafl, K. ([s.d.]). Methodological issues in nursing research. The integrative review: updated methodology.
Yang, J. C., Sun, Y., Xu, C. X., Dang, Q. L., Li, L., Xu, Y. G., Song, Y. J., & Yan, H. (2015). Correlation between red blood cell transfusion volume and mortality in patients with massive blood transfusion: A large multicenter retrospective study. Experimental and Therapeutic Medicine, 9(1), 137–142. https://doi.org/10.3892/etm.2014.2068
Crossetti, M. G. O. (2012). Revisão integrativa de pesquisa na enfermagem o rigor cientifico que lhe é exigido. Rev Gaúcha Enferm. 33(2):8-9.
Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. Editora da UFSM. https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1.
Risemberg, R. I. C., Wakin, M., & Shitsuka, R. (2026). A importância da metodologia científica no desenvolvimento de artigos científicos. E-Acadêmica. 7(1), e0171675. https://eacademica.org/eacademica/article/view/675
Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research. 104, 333-9. https://doi.org/10.1016/j.jbusres.2019.07.039
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Copyright (c) 2026 Flávia Helena Fornazeiro Abegão , Renata London Rodrigues Nascimento, Nathalia de Souza Fernandes, Kênio Salgueiro Okamura, Isabella Marcondes Ibrahim, Vanessa Bernardo Nunes
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