Effects of different electrolyte solutions on blood washing in cardiac surgery with cardiopulmonary bypass / 中华麻醉学杂志

Objective:To evaluate the effects of different electrolyte solutions on blood washing in cardiac surgery with cardiopulmonary bypass (CPB).Methods:Sixty patients, aged 18-80 yr, weighing 50-100 kg, undergoing cardiac surgery with CPB with expected banked blood transfusion 4-6 U in our hospital, were divided into 3 groups ( n=20 each) by a random number table method: compound electrolyte injection group (group A), sodium bicarbonate Ringer′s solution group (group B) and normal saline group (group C). Banked blood and salvaged autologous blood were washed with compound electrolyte injection, sodium bicarbonate Ringer′s solution and normal saline.Banked and autologous blood was collected before washing and immediately after washing for blood gas analysis.The osmotic fragility of red blood cells was measured by colorimetry, and the concentration of 2, 3-diphosphoglycerate (2, 3-DPG) was determined by enzyme-linked immunosorbent assay. Results:Compared with the baseline before washing, the concentrations of K +, Glu and Lac in banked blood were significantly decreased, the concentrations of K + in banked blood were increased, and the concentrations of Glu and Lac in autologous blood were decreased, the osmotic fragility of erythrocytes was increased, and the concentrations of 2, 3-DPG in banked and autologous blood were increased after washing in the three groups ( P<0.05). Compared with group C, the concentrations of Na + and Cl - in banked and autologous blood were significantly decreased, the concentrations of K + in banked and autologous blood were increased, the osmotic fragility of erythrocytes in banked and autologous blood was decreased, and the concentrations of 2, 3-DPG in banked and autologous blood were increased in A and B groups ( P<0.05). Compared with A and C groups, BE in banked and autologous blood were significantly increased after washing in group B than in A and C groups ( P<0.05). After washing, Ca 2+ was detected in banked and autologous blood in group B, however, Ca 2+ was not detected in banked and autologous blood in group A and group C. Conclusions:Compound electrolyte solution and sodium bicarbonate Ringer′s solution provide better efficacy when used for blood washing in cardiac surgery with CPB, and sodium bicarbonate Ringer′s solution can also improve the acidic and calcium-free internal environment of blood.

Autologous blood salvage in cardiac surgery: clinical evaluation, efficacy and levels of residual heparin

ABSTRACT Objective: Intraoperative blood salvage (cell saver technique) in cardiac surgery is universally used in surgical procedures with a marked risk of blood loss. The primary objectives of this study were to determine the concentration of residual heparin in the final product that is reinfused into the patient in the operating room and to evaluate the efficacy and safety of the cell saver technique. Method: Twelve patients undergoing elective cardiac surgery were enrolled in this study. Using the XTRA Autotransfusion System, blood samples were collected from the cardiotomy reservoir, both prior to blood processing (pre-sample) and after it, directly from the bag with processed product (post-sample). Hematocrit and hemoglobin levels, the protein, albumin and residual heparin concentrations, hemolysis index, and the platelet, erythrocyte and leukocyte counts were measured. Results: Hematocrit and hemoglobin levels and red blood cell counts were higher in post-processing samples, with a mean variation of 54.78%, 19.81 g/dl and 6.84 × 106/mm3, respectively (p < 0.001). The mean hematocrit of the processed bag was 63.49 g/dl (range: 57.2-67.5). The residual heparin levels were ≤0.1 IU/ml in all post-treatment analyses (p = 0.003). No related adverse events were observed. Conclusion: The reduced residual heparin values (≤0.1 IU/ml) in processed blood found in this study are extremely important, as they are consistent with the American Association of Blood Banks guidelines, which establish target values below 0.5 IU/ml. The procedure was effective, safe and compliant with legal requirements and the available international literature.

El recuperador celular y necesidad transfusional en pacientes intervenidos de cirugía cardíaca / The cell saver and the transfusional need in patients undergoing cardiac surgery

Resumen Objetivo Los pacientes intervenidos de cirugía cardíaca presentan riesgo elevado de ser transfundidos con sangre durante el postoperatorio, debido al descenso de sus cifras de hemoglobina y hematocrito. Una de las alternativas a la transfusión sanguínea es el uso del recuperador celular intraquirúrgico. El objetivo de este estudio fue identificar si el uso del recuperador celular intraquirúgico disminuye la tasa transfusional durante el postoperatorio inmediato. También se ven las complicaciones postquirúrgicas inmediatas en ambos grupos. Material y Métodos Estudio analítico, prospectivo con dos cohortes de pacientes distribuidos en grupo control (162) y grupo intervención (162). Se analizarón variables sociodemográficas, de sus diagnósticos y tratamientos quirúrgicos, tiempos de isquemia cardíaca, hemoglobina, hematocrito, transfusión sanguínea y hemorragias, así como variables propias del recuperador celular. Las complicaciones estudiadas fueron; hemoglobinuria, fiebre, náuseas y vómitos. Se obtuvo el consentimiento informado de todos los pacientes y se sometió los datos al paquete estadístico SPSS versión 22.0. Resultados Las cifras de hemoglobina y hematocrito de los pacientes después de ser intervenido quirúrgicamente, fueron diferentes entre los grupos respectivamente (GC, 8,3 g/dL, 22,8%. GI,10,4 g/dL, 31,1%). Coincidiendo que los mayores transfundidos fueron los del grupo control (18,2%) frente al grupo intervención (3,9%). El grupo que presentó mayor complicación fue el grupo intervención (13,6%) que eran los que utilizaron el recuperador celular. Siendo la hemoglobinuria (82%) la mayor complicación. Conclusiones Los pacientes que utilizaron el recuperador celular disminuyeron la necesidad transfusional, sin embargo, fueron los que mayor incidencia de hemoglobinuria padecieron.

Objetive Patients undergoing cardiac surgery are at high risk of being transfused with blood during the postoperative period, due to the decrease in haemoglobin and haematocrit levels. One of the alternatives to blood transfusion is the use of the intraoperative cell saver. The objective of this study was to identify whether the use of the intra-uremic cell saver decreases the transfusional rate during the immediate postoperative period. The immediate postoperative complications were also demonstrated in both groups. Material and Methods Analytical, prospective study with two cohorts of patients distributed in control group (162) and intervention group (162). Sociodemographic variables, their diagnoses and surgical treatments, time of cardiac ischemia, haemoglobin, haematocrit, blood transfusion and haemorrhages, as well as variables specific to the cell saver were analyzed. The complications studied were; haemoglobinuria, fever, nausea and vomiting. The informed consent of all the patients was obtained and the data was submitted to the statistical package SPSS version 22.0. Results The haemoglobin and haematocrit values of patients after surgery were different between groups (GC, 8.3 g/dl, 22.8%, GI, 10.4 g/dl, 31.1 g %). Coinciding that the major transfused were those of the control group (18.2%) versus the intervention group (3.9%). The group that presented the greatest complication was the intervention group (13.6%) who were those who used the cell saver. Hemoglobinuria (82%) being the major complication. Conclusions Patients who used the cell saver decreased the need for transfusion, but were the ones with the highest incidence of hemoglobinuria.

Efecto del sistema de recuperación de sangre autóloga y transfusiones homólogas en pacientes quirúrgicos de alta complejidad / Effect of homologous transfusions and the autologous blood recovery system in highly complex surgical patients

Introducción: la transfusión autóloga presenta tres modalidades: transfusión autóloga con predepósito, hemodilución preoperatoria (normovolémica o hipervolémica) y el sistema de recuperación de sangre autóloga (cell saver) intraoperatoria o posoperatoria. Objetivo: demostrar la efectividad del uso del sistema de recuperación de sangre autóloga en pacientes quirúrgicos de alta complejidad en el Hospital Alcívar. Método: estudio retrospectivo, no experimental, de observación indirecta, con análisis correlacional. La muestra fue de 112 pacientes intervenidos por afecciones cardiovasculares, ortopédicas y traumatológicas, incluidos según criterios de inclusión y exclusión. Se utilizó cell saver en 56 pacientes, y 56 pacientes utilizaron transfusiones de sangre homóloga. Resultados. el cell saver fue beneficioso en 93 por ciento de los pacientes; la morbilidad y la mortalidad disminuyeron, principalmente en los pacientes intervenidos de cualquier afección cardiovascular y aumentó el índice costo/beneficio, debido a que se priorizaron los recursos económicos. En traumatología y ortopedia no fue muy beneficioso, pues la cantidad de sangre recuperada fluctuó entre 300 y 500 mL en intervenciones convencionales, lo que motivó el uso de hemoderivados y aumentó el costo. En resecciones tumorales e instrumentaciones en diferentes segmentos de la columna vertebral se recuperó hasta 800 mL de sangre, lo que resultó significativo. La tasa de complicaciones fue menor en pacientes que utilizaron cell saver (7 por ciento) frente a los pacientes que utilizaron hemoderivados homólogos (32 por ciento). Se constató una menor estancia hospitalaria en el grupo cell saver (1-20 días) en comparación con los que usaron hemoderivados homólogos (> 10 días, en 5 casos fue mayor 21 días). Conclusiones: el uso de sistema de recuperación de sangre autóloga constituye un procedimiento efectivo para infundir hemoderivados con mayor seguridad(AU)

Introduction: Autologous transfusion has three modalities: autologous transfusion with predeposit, preoperative hemodilution (normovolemic or hypervolemic), and the system for autologous blood recovery (cell saver), whether intraoperative or postoperative. Objective: To show the effectiveness of the use of the autologous blood recovery system in highly complex surgical patients at Alcívar Hospital. Method: Nonexperimental, retrospective study, of indirect observation and with correlational analysis. The sample consisted of 112 patients who underwent surgery for cardiovascular, orthopedic and traumatological conditions, chosen based on inclusion and exclusion criteria. The cell saver system was used in 56 patients and 56 patients used homologous blood transfusions. Results: The cell saver system was beneficial in 93 percent of patients; morbidity and mortality decreased, mainly in patients operated for any cardiovascular condition, while the cost-benefit ratio increased, due to the fact prioritization of economic resources. In traumatology and orthopedics, it was not so beneficial, since the amount of blood recovered fluctuated between 300 and 500 mL in conventional interventions, which motivated the use of blood products and increased the cost. In tumor resections and instrumentation of different spine segments, up to 800 mL of blood were recovered, which was significant. The complication rate was lower in patients who used the cell saver system (7 percent), compared to patients who used homologous blood products (32 percent). A shorter hospital stay was observed in the cell saver group (1-20 days), compared to those who used homologous blood products (over 10 days, while in 5 cases it was over 21 days). Conclusions: The use of the autologous blood recovery system is an effective procedure to infuse blood products with greater safety(AU)

Implementation of an obstetric cell salvage service in a tertiary women's hospital

<p><b>INTRODUCTION</b>Intraoperative cell salvage (ICS) is an important aspect of patient blood management programmes. An ICS service was introduced at KK Women's and Children's Hospital, Singapore, from 2 May 2011 to 30 April 2013 to aid in the management of massive obstetric haemorrhage.</p><p><b>METHODS</b>With support from the Ministry of Health's Healthcare Quality Improvement and Innovation Fund, a workgroup comprising obstetricians, anaesthetists and nursing staff was formed to develop training requirements, clinical guidelines and protocols for implementing ICS using the Haemonetics Cell Saver 5. Pregnant women with an anticipated blood loss of > 1,000 mL during Caesarean delivery, a baseline haemoglobin level of < 10 g/dL, rare blood types and who had refused donor blood were recruited to the service after obtaining informed consent.</p><p><b>RESULTS</b>A total of 11 women were recruited to the ICS service; the primary indications were placenta praevia and placenta accreta. Median blood loss in these 11 patients was 1,500 (range 400-3,000) mL. In four patients, adequate autologous blood was collected to initiate processing and salvaged, processed blood was successfully reinfused (mean 381.3 [range 223.0-700.0] mL). Median blood loss among these four patients was 2,000 (range 2,000-3,000) mL. No adverse event occurred following autologous transfusion. Mean immediate postoperative haemoglobin level was 8.0 (range 7.1-9.4) g/dL.</p><p><b>CONCLUSION</b>The implementation of an obstetric ICS service in our institution was successful. Future studies should seek to address the cost-effectiveness of ICS in reducing allogeneic blood utilisation.</p>

A Clinical Experience of Massive Transfusion in a Patient with Cardiac Arrest Resulting from Abdominal Aortic Aneurysm Rupture / 대한수혈학회지

We report on a case of successful management of a patient with abdominal aortic rupture requiring massive blood transfusion during the peri-operative period. The patient had fully recovered 19 days after the operation, through intra-operative cardiac arrest and massive transfusion. We analyze a process of blood transfusion and related complications resulting from massive transfusion in order to establish a treatment for peri-operative patients with hypovolemic shock.

An observational study of intraoperative transfusion management in a cardiac surgical unit in Trinidad and Tobago / Estudio observacional del manejo de la transfusión intraoperatoria en una unidad de cirugía cardíaca en Trinidad y Tobago

OBJECTIVE: To investigate the intraoperative transfusion requirements in off-pump coronary artery bypass grafting (OPCABG) and the cost implication of blood products and cell savers on a background of limited resources. METHODS: Prospective data collection identified 60 patients undergoing OPCABG surgery at the Eric Williams Medical Sciences Complex, Trinidad and Tobago. Data relating to these patients (including preoperative haemoglobin (Hb), graft number, presence of diabetes, ejection fraction, preoperative serum creatinine, intraoperative blood use and blood loss) and costing for cell saver disposables and prepared donor (or allogenic) blood were obtained. RESULTS: Twenty units of packed red blood cells (pRBCs) were given in theatre to 27% (16 of 60) of patients. Transfusion requirement was significantly lower in patients with fewer grafts, higher pre-operative Hb level and non-diabetic patients. Cell saver disposables and one unit of pRBCs were estimated to cost TT$5000 and TT$1700, respectively. Each patient's transfusion cost TT$2125.00 per unit. CONCLUSION: The study demonstrates the financial implications of routine cell saver use in OPCABG in a setting oflimited resources. The cost-effectiveness ofroutine cell saver use remains to be elucidated, but we recommend the selective use of cell savers in patients who are at a higher risk for transfusion.

OBJETIVO: Investigar los requisitos de la transfusión intra-operatoria en el bypass coronario con injerto sin circulación extracorpórea (OPCABG), y la implicación del costo de los hemoderivados y los recuperadores celulares en un contexto de recursos limitados. MÉTODOS: La recopilación de datos prospectivos identificó a 60 pacientes sometidos a cirugía OPCABG en el Complejo de Ciencias Médicas Eric Williams, en Trinidad y Tobago. Se obtuvieron datos en relación con estos pacientes (incluyendo la hemoglobina preoperatoria (Hb), número de injertos, presencia de diabetes, fracción de eyección, creatinina sérica preoperatoria, uso y pérdida de sangre preoperatorios) así como el costo de todos los recuperadores celulares desechables, y la sangre del donante preparada (o alogénica). RESULTADOS: Veinte unidades de glóbulos rojos empaquetados (pRBCs) fueron transfundidas en el salón de operaciones al 27% (16 de 60) de los pacientes. La necesidad de la transfusión fue significativamente más baja en los pacientes con menos injertos, nivel preoperatorio de hemoglobina (Hb) más alto, y en los pacientes no diabéticos. El costo de los recuperadores celulares desechables y una unidad de pRBCs fueron estimados en 5000 TTD y 1700 TTD, respectivamente. La transfusión de cada paciente costó 2125 TTD por unidad. CONCLUSIÓN: El estudio demuestra las implicaciones financieras del uso de recuperadores celulares de rutina en el OPCABG en un contexto de recursos limitados. El costo-efectividad del uso de los recuperadores celulares de rutina sigue siendo un asunto que necesita aclaración. No obstante, se recomienda el uso selectivo de recuperadores de células en pacientes con alto riesgo a causa de la transfusión.

The Effect of Intraoperative Autotransfusion using a Continuous Autotransfusion System (CATS(R)) on for Homologous Transfusion in Children / 대한마취과학회지

BACKGROUND: Until recently, it was not easy to conduct intraoperative autotransfusion in children due to technical limitations, however, due to advanced technology this is now possible. This study was conducted to determine if the intraoperative use of the continuous autotransfusion system (CATS(R)) can reduce homologous transfusion during pediatric orthopaedic surgery. METHODS: Fifty-five children scheduled for elective orthopaedic surgery were reviewed and divided into two groups according to the availability of the CATS(R). The control group (n = 29) had surgery without the cell saver, whereas the CATS(R) group (n = 26) had surgery with the cell saver. The amounts of perioperative homologous transfusion were then compared between the two groups. RESULTS: The amount of homologous blood transfusion required during the operation was significantly less in the CATS(R) group 5 +/- 10 (ml/kg) than in the control group 15 +/- 13 (ml/kg) (P < 0.01). There was no difference in the amount of homologous blood transfusion required after operation between the groups. CONCLUSIONS: CATS(R) can reduce the need for intraoperative homologous transfusion during pediatric orthopaedic surgery.

Impact of blood salvage during liver transplantation on reduction in transfusion requirements / Impacto do uso do cell saver na redução de transfusão sanguínea durante o transplante de fígado

PURPOSE: The aim of this study was to analyse the changes in transfusion requirements, in patients submitted to orthotopic liver transpantation from cadaveric donors, with the use of intraoperative red blood cell salvage (Cell Saver). METHODS: Data from 41 transplants were analysed. Intraoperative blood loss was calculated from the cell salvage, suction and the swabs. The autologous and heterologous transfusions were recorded The red blood salvage was performed using the Cell Saver 5 System (Haemonetics).. For analysis the patients were divided in two groups: one that used the Cell Saver and another that didn't. RESULTS: The median age of the patients was 50 years and the main indication for liver transplantation was cirrhosis (35 cases - 85.3 percent). The median blood loss was 8362 + 3994 ml (with the Cell Saver) and 10824 + 7002 ml (without the Cell Saver) and the median transfusion of heterologous packed red blood cells was 9,6 + 8 units (with the Cell Saver) compared to 22,3 + 21 units (without the Cell Saver). CONCLUSIONS: The Cells Saver has the potential to reduce the need for heterologous blood transfusion reducing the risks of transmissible diseases.

OBJETIVO: O objetivo desse estudo foi analisar as mundanças na quantidade de transfusão necessária com uso do Intraoperative red blood cell salvage (Cell saver), em pacientes submetidos a transplante ortotópico de fígado, doador cadáver. MÉTODOS: Foram avaliados dados de 41 pacientes submetidos a transplante de fígado. O sangramento foi calculado de acordo com débito do aspirador, compressas e captação do Cell saver. A reposição necessária foi avaliada de acordo com a quantidade de transfusão heteróloga e autóloga. Para análise dos dados os pacientes foram dividos em dois grupos: com e sem uso de Cell saver. RESULTADOS: A mediana de idade foi 50 anos e principal indicação de transplante foi cirrose hepática com 35 casos (85,3 por cento). A mediana de sangramento durante o procedimento cirúrgico 8362 + 3994 ml (com cell saver) e 10824 + 7002 ml (sem cell saver) e a mediana de transfusão de concentrado de hemácias heterólogo, durante o período de internação hospitalar 9,6 + 8 unidades (com cell saver) compar 22,3 + 21 unidades (sem cell saver). CONCLUSÃO: Uso de Cell Saver tem um potential para reduzir a quantidade de transfusão heteróloga, dimuindo o risco de transmissão de doenças.

Anesthetic Management for Abdominal Aortic Aneurysm Surgey without Homologous Blood Transfusion in Adult Jehovah'sWitness : A case report

Jehovah's Witnesses present a challenge for the anesthesia professionals on account of their refusal to accept blood and blood products. Therefore, anesthesiologists must be able to individualize their treatment depending on the patients' condition. We report a case of a stent removal and aorto-biiliac bypass surgery in a Jehovah's Witness. A 69 year-old, hypertensive man presented with claudication of both lower extremities due to the distal migration of an endoaneurysmal stent. According to his previous medical history, he had a lacunar infarction in the right middle cerebral artery territory, ischemic coronary artery disease with a stent in situ, and a stent inserted for an abdominal aortic aneurysm by radiological intervention. Because he strongly refused a transfusion, human recombinant erythropoietin was used before surgery. After the erythropoietin treatment, hemoglobin level increased to 14.8 g/dl (hematocrit 47.6%). During the operation, closed-circuit cell saver was used and transfused autologous blood was saved by acute normovolemic hemodilution. The patient recovered uneventfully from the anesthesia and was transferred to the intensive care unit. He was discharged on the ninth postoperative day without complications with a hematocrit level of 28.9%.

The Comparison of the Concentration of Free Hemoglobin in Packed RBC, Intraoperative Salvaged Blood and CPB Residual Blood during Cardiac Surgery / 대한마취과학회지

BACKGROUND: Intraoperative autotransfusion or residual blood in a cardiopulmonary bypass (CPB) circuit has been used to reduce the need for an homologous blood transfusion during cardiac surgery. However, it may contain some free hemoglobin released from damaged cells. The load of blood containing free hemoglobin may cause renal dysfunction. We measured the amount of free hemoglobin in banked blood, cell saver blood and CPB blood to evaluate what is the least hemolytic blood transfused in cardiac surgery. METHODS: This study was performed in 20 patients undergoing cardiac surgery. In each patient, the banked blood, intraoperative salvaged blood with a cell saver and CPB residual blood were sampled at the end of the operation. The concentration of free hemoglobin, hemoglobin and platelet counts were measured in these blood samples and percent of hemolysis was calculated (%hemolysis = [free hemoglobin] / [free hemoglobin hemoglobin]) RESULTS: In salvaged blood with a cell saver, CPB residual blood and banked blood, hemoglobin concentrations were 20.1+/-2.7 g/dl, 8.0+/-1.1 g/dl, and 22.2+/-2.7 g/dl, respectively. Free hemoglobin concentrations were 336.6+/-239.5 mg/dl, 49.2+/-26.8 mg/dl, and 279.5+/-167.5 mg/dl respectively. Platelet counts were 26.1+/-22.2X10(3)/mm3, 116.8+/-56.5X10(3)/mm3, and 94.9+/-43.6X10(3)/mm3 respectively. % Hemolysis were 1.6+/-1.1%, 0.6+/-0.4%, and 1.2+/-0.7% respectively. In the comparison between the salvaged blood with a cell saver and CPB residual blood, free hemoglobin concentration, % hemolysis, and platelet counts had positive correlations (r = 0.8, 0.7, and 0.6). CONCLUSIONS: In twenty cardiac surgeries, CPB residual blood had a lower free hemoglobin level than the other two blood groups. The platelet counts in CPB residual blood were higher than those in cell saver blood but did not differ from those in banked blood. Therefore, CPB residual blood was the least hemolytic blood among the three blood groups when a transfusion was performed in cardiac surgery.

Effects of Autotransfusion using Cell Saver in Open Heart Surgery / 대한흉부외과학회지

Homologous blood transfusion entails substantial risks, including allergic reactions, transmission diseases such as hepatitis, acquired immunodeficiency syndrome. Autotransfusion system is a common method of reducing the need for homologous blood transfusion during cardiac operation. Between July 1993 and July 1995, a series of 40 patients undergoing open heart surgery was selected to an autotransfusion group (n=20) or a control group (n=20). The cell saver system (AT1000, Electromedics, Englewood, CO, USA) was employed for autotransfusion. With this system, shed blood in operative field during cardiopulmonary bypass (CPB) and remained blood in cardiotomy reservior after CPB was aspirated by means of a locally heparinized collecting system. After centrifuge salvaged blood, the resulting red cell concentrate reinfused subsequently. The amounts of blood loss were 766.5+/-121.3 ml in cell saver group, 770.1+/-113.6 ml in control group, and there were no significant differences between two groups (P=NS). The amounts of blood transfused were 2.91+/-1.72 units in cell saver group, 4.82+/-1.72 units in control group. Composition of processed blood by cell saver was hemoglobin 17.4 gm%, hematocrit 56.4%, RBC 5,780,000/ul, WBC 9,900/ul, and platelet 33,000/ul. There was no complication related to cell saver. Conclusively, cell saver autotransfusion system is safe, effective method for reducing the homologous blood trasfusion in cardiac surgery.

Use of the Cell Saver in Orthopedic Spinal Surgery / 대한마취과학회지

BACKGROUND: Methods to reduce the amount of blood transfusion include perioperative hemodilution, hypotensive anesthesia, the transfusion of previously deposited autologous blood, and intraoperative autotransfusion used the cell saver. The purpose of this study is to evaluate the effect of the use of the cell saver in orthopedic spinal surgery. METHODS: One hundred and one patients for orthopedic spinal surgery were involved in this study and divided into two groups: group 1 (no used cell saver, n=51) and group 2 (used cell saver, n=50). We checked transfusion amounts during operation and the changes of hematocrit after operation. RESULTS: The amount of blood obtained from cell saver apparatus was 1220 +/- 651 ml (mean SD). Hematocrit of the autologous blood from this apparatus was 48.5 +/- 2.5%. Amounts of blood transfusion during operation were 4.1 +/- 0.9 IU (400 ml/IU) in group 1 and 2.5 +/- 0.7 IU in group 2 (p<0.05). The hematocrit was markedly decreased at the postoperative 2 and 3 days in group 2 (p<0.05). CONCLUSIONS: This study suggested that intraoperative salvage technique with cell saver apparatus could decrease the use of bank blood by 40% in orthopedic spinal surgery. However, we should be prepare the blood for the decrease of the hematocrit at the postoperative 2 and 3 days.

Eliminating Homologous Blood Transfusion Using a Cell Saver during Abdominal Aortic Aneurysm Repair / 日本心臓血管外科学会雑誌

The purpose of this study was to determine the effect of intraoperative autologous blood salvage during elective abdominal aortic aneurysm repair with Cell Saver 4 (Heamonetics Inc.). Fifty patients prospectively received intraoperative autologous transfusion (Group CS; <i>n</i>=50, 1991-94) and 25 received no intraoperative autologous transfusion (Group NCS; <i>n</i>=25, 1983-91). Only 7 patients in Group NCS received no homologous blood (28%), while 43 in Group CS received autologous blood transfusion (86%). There was no difference between the groups with respect to postoperative platelets counts or serum concentrations of total protein, albumin, BUN and LDH. We conclude that the use of the Cell Saver 4 reduces perioperative homologous blood during elective aortic aneurysm repair.

Intraoperative Blood Salvage and Transfusion During Spinal Surgery / 대한마취과학회지

25 Patients were received major spinal surgeries at main operating theater of Kangnam General Hospital from May 1990 to December 1990 by using the Haemonetics cell saver which was employed as an intraoperative blood salvage and autologous blood transfuser. The products of washed red blood cells were an average of 1490 cc packed RBC per case. Under the Light Microscopy, Washed RBC disclosed the morphologies of normal RBC size and shape. Fragmented RBCs or cell debris were not found and in one case agglutinated and denaturated RBCs were seen. While 20 patients were received spinal surgery prior to the utilization of cell saver, an average of 7.85 units of banked whole blood was transfused compared with 5.55 units in the cases of using the cell saver (p<0.05). Homologous banked blood utilization during spinal surgery declined more than 30% with the use of the cell saver. There was no evidence of infection, renal and/or hepatic failure related to the use of the cell saver. Haemonetics cell saver appeared to be safe, efficient and more over in some instanes life saving.