| Cell salvage as part of a blood conservation strategy in anaesthesia. | |
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MedLine Citation:
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PMID: 20802228 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The use of intraoperative cell salvage and autologous blood transfusion has become an important method of blood conservation. The main aim of autologous transfusion is to reduce the need for allogeneic blood transfusion and its associated complications. Allogeneic blood transfusion has been associated with increased risk of tumour recurrence, postoperative infection, acute lung injury, perioperative myocardial infarction, postoperative low-output cardiac failure, and increased mortality. We have reviewed the current evidence for cell salvage in modern surgical practice and examined the controversial issues, such as the use of cell salvage in obstetrics, and in patients with malignancy, or intra-abdominal or systemic sepsis. Cell salvage has been demonstrated to be safe and effective at reducing allogeneic blood transfusion requirements in adult elective surgery, with stronger evidence in cardiac and orthopaedic surgery. Prolonged use of cell salvage with large-volume autotransfusion may be associated with dilution of clotting factors and thrombocytopenia, and regular laboratory or near-patient monitoring is required, along with appropriate blood product use. Cell salvage should be considered in all cases where significant blood loss (>1000 ml) is expected or possible, where patients refuse allogeneic blood products or they are anaemic. The use of cell salvage in combination with a leucocyte depletion filter appears to be safe in obstetrics and cases of malignancy; however, further trials are required before definitive guidance may be provided. The only absolute contraindication to the use of cell salvage and autologous blood transfusion is patient refusal. |
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Authors:
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A Ashworth; A A Klein |
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Publication Detail:
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Type: Journal Article; Review Date: 2010-08-28 |
Journal Detail:
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Title: British journal of anaesthesia Volume: 105 ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-14 Completed Date: 2010-10-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
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Languages: eng Pagination: 401-16 Citation Subset: IM |
Affiliation:
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Department of Anaesthesia and Critical Care, Papworth Hospital, Papworth Everard, Cambridge CB23 3RE, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Loss, Surgical Blood Preservation / methods Blood Transfusion / adverse effects Blood Transfusion, Autologous / adverse effects, methods* Humans Intraoperative Care / methods Neoplasms / surgery Postpartum Hemorrhage / therapy Tissue and Organ Harvesting / methods* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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