Methods	A randomised controlled trial was conducted to evaluate the safety and effectiveness of intra-operative cell salvage and autotransfusion of washed salvaged red blood cells after first-time coronary artery bypass grafting (CABG) performed on the beating heart. Patients were assigned to one of two randomised group, in a 1:1 ratio by using block randomisation. Allocations were generated by a card system and concealed in sealed opaque envelopes. Patients who had given consent were randomised immediately before surgery
Participants	61 patients undergoing cardiac surgery were randomly allocated to one of two groups: Group 1 (Autotransfusion group): n=30; M//F=25//5; mean (sd) age = 62.3 (9.3) years Group 2 (Control group): n=31; M//F=23//8; mean (sd) age = 66.4 (7.6) years
Interventions	Group 1: Autotransfusion group (Dideco Compact autotransfusion system) underwent intra-operative cell salvage with autotransfusion of washed salvaged red blood cells at the completion of the operative procedure. All blood lost, from skin incision to skin closure, was salvaged via a single-lumen suction tube flushed with heparinised saline and connected to the closed rigid collection chamber of the Dideco Compact autotransfusion device at high-pressure suction. Before autotransfusion, the heparinised salvaged intra-operative blood underwent a washing process, with resuspension of the red blood cells in saline, to a Hct of approximately 0.6. This red blood cell suspension was then transferred to a sterile collecting bag that was disconnected from the autotransfuser and administered via a standard blood giving set. Salvaged washed red blood cells were autotransfused at the time of skin closure. Group 2: Control group received standard care without autotransfusion.
Outcomes	Outcomes reported: number of patients transfused allogeneic blood, volume of blood collected by the cell saver, volume of blood re-transfused from the cell saver, number of patients transfused fresh frozen plasma (FFP), number of patients transfused platelets, blood loss, mortality, adverse events
Notes	Transfusion threshold: the threshold for transfusion of allogeneic blood was a haemoglobin level less than 8.0g/dL or a haematocrit less than 0.23. In patients with excessive blood loss and cardiovascular instability, blood was given at the discretion of anaesthetic or intensive care unit staff
Risk of bias
Bias	Authors’ judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Method used to generate allocation sequences was adequate.
Allocation concealment (selection bias)	High risk	Method used to conceal treatment allocation was inadequate.
Blinding (performance bias and detection bias) All outcomes	High risk