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cell saver guideline

I Pekrul, G Wittmann, P Möhnle
Based on the German Transfusion Law, the periodically updated guidelines "Richtlinien zur Gewinnung von Blut und Blutbestandteilen und zur Anwendung von Blutprodukten" ("Hämotherapierichtlinien") are intended to provide the current knowledge and state of the art of blood transfusion practice in Germany. The novel update 2017 contains relevant changes for blood donation, especially the extension of the exclusion period of persons at risk for sexually transmitted HBV, HCV and HIV diseases to 12 months...
January 2018: Der Anaesthesist
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
June 2017: Current Opinion in Anaesthesiology
Eileen Lew, Shephali Tagore
INTRODUCTION: 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. METHODS: 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...
August 2015: Singapore Medical Journal
Patrick D Kelly, Scott L Parker, Stephen K Mendenhall, Jesse E Bible, Priya Sivasubramaniam, David N Shau, Matthew J McGirt, Clinton J Devin
STUDY DESIGN: Mixed retrospective-prospective cohort study. OBJECTIVE: To characterize practice patterns for the use of Cell Saver at our institution, investigate its cost-effectiveness, and propose a new tool for patient selection. SUMMARY OF BACKGROUND DATA: Blood loss is an exceedingly common complication of spine surgery, and Cell Saver intraoperative cell salvage has been used to decrease reliance on allogeneic blood transfusions for blood volume replacement...
September 1, 2015: Spine
Akimasa Morisaki, Atsushi Nakahira, Yasuyuki Sasaki, Hidekazu Hirai, Yuko Okada, Shigefumi Suehiro, Toshihiko Shibata
OBJECTIVES: Guidelines recommend the avoidance of direct return of pericardial blood based on evidence from coronary surgery. A continuous auto-transfusion system (CATS) can be a good alternative to cardiotomy suction by reinfusing aspirated pericardial blood without the necessity of intermittent collection. To clarify the effects of direct return of pericardial blood in aortic valve replacement (AVR), we compared the effects of cardiotomy suction and an alternative CATS on perioperative coagulofibrinolysis and inflammation systems, and clinical outcomes...
September 2013: Interactive Cardiovascular and Thoracic Surgery
Luis D Pacheco, George R Saade, Alfredo F Gei, Gary D V Hankins
Hemorrhagic shock is the most common form of shock encountered in obstetric practice. Interventions that may limit transfusion requirements include normovolemic hemodilution, use of recombinant activated factor VII, selective embolization of pelvic vessels by interventional radiology, and the use of the cell saver intraoperatively. Current understanding of the mechanisms of acute coagulopathy calls into question the current transfusion guidelines, leading to a tendency to apply massive transfusion protocols based on hemostatic resuscitation despite lack of prospective data...
December 2011: American Journal of Obstetrics and Gynecology
Luis D Pacheco, Alfredo F Gei
Obstetric hemorrhage is one of the most common causes of maternal morbidity and mortality worldwide, and abnormal placentation, including placenta accreta, is currently the most common indication for peripartum hysterectomy. Prenatal identification of these cases and early referral to centers with the capability to manage them will likely result in improved outcomes. Interventions that may limit transfusion requirements include normovolemic hemodilution, selective embolization of pelvic vessels by interventional radiology, conservative management of accretism in a few selected cases, and the use of the cell saver intraoperatively...
June 2011: Obstetrics and Gynecology Clinics of North America
Chia-Chen Wu, Shung-Tai Ho, Chung-Yuan Lin, Fan-Yen Lee
BACKGROUND: The safety of homologous blood transfusion has become a major concern for patients and physicians. Current transfusion practice is highly variable and may be associated with inappropriate blood use. Inotropic agents have been almost routinely administered perioperatively to patients undergoing cardiac surgery to overcome low cardiac output due to cardiopulmonary bypass (CPB) and cardioplegia-induced cardiac ischemic arrest. In this study, we evaluated the feasibility of bloodless and non-inotropic open-heart surgery...
March 2010: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
Jennifer M Weiss, David Skaggs, John Tanner, Vernon Tolo
STUDY DESIGN: Review of the use of Cell Saver in a non-randomized group of patients undergoing spinal fusion for scoliosis. OBJECTIVES: To determine the efficacy of the use of Cell Saver for spinal fusions for scoliosis. Although Cell Saver is widely used in scoliosis surgery, it is not clear whether its use decreases the need for other transfusions or whether there are certain patients more likely to benefit from its use. The blood collected by Cell Saver intraoperatively is not always of sufficient volume to be returned to the patient, and there are no current guidelines addressing the amount that is likely to be returned to the patient...
October 2007: Journal of Children's Orthopaedics
Ravi Taneja, Philip Fernandes, Gulshan Marwaha, Davy Cheng, Daniel Bainbridge
OBJECTIVE: To determine which strategies are currently used for (anti)coagulation management and blood conservation during cardiac surgery in Canada. DESIGN: Institutional survey. SETTING: University hospital. PARTICIPANTS: All sites performing cardiac surgery in Canada. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The response rate was 85%. Anticoagulation with heparin is monitored routinely through the activated coagulation time (ACT)...
October 2008: Journal of Cardiothoracic and Vascular Anesthesia
Aaron Glynn, Thomas McCarthy, Maire McCarroll, Paraic Murray
The use of allogeneic blood is associated with many complications. A baseline audit performed in our institution in 2000 showed that 11% of patients undergoing primary total knee arthroplasty (TKA) required post-operative transfusion. Following this audit, patients undergoing primary TKA were no longer routinely cross matched, a Haemovigilance Nurse was employed in compliance with the National Blood Users Group guidelines, and post-operative cell salvage was introduced for patients with a preoperative haemoglobin level of less than 12 g/dl...
January 2006: Acta Orthopaedica Belgica
Kevin L Garvin, Connie A Feschuk, Todd D Sekundiak, Elizabeth R Lyden
UNLABELLED: Blood transfusions frequently are required after revision total hip arthroplasty, and although autologous and allogenic transfusions are effective in replacing blood loss, they are not without risks. To reduce the dependency on these types of transfusions, intraoperative blood collection and return by autotransfusion replacement systems are being used as an alternative or conjunctive therapy. We retrospectively reviewed 147 hip revision surgeries to determine if autotransfusion replacement systems return from the Cell Saver or the OrthoPat decreased the need for allogenic blood...
December 2005: Clinical Orthopaedics and related Research
E A Bringeland, K Ramstad, E W Nielsen, L Andersen, W Amundsen, T E Mollnes
In spring 1992 a blood conservation programme was established at Nordland Central Hospital with emphasis on indications for blood transfusion and intraoperative blood salvage (cell-saver). Medical records from all patients who underwent hip arthroplasty during the period 1 June 1991 to 28 February 1994 were examined. Mean transfusion of homologous SAGMAN-blood (bank blood) was substantially reduced during the period: for total prosthesis (n = 192) from 2.6 to 1.1 units per operation (p < 0.0001) and for hemiprosthesis (n = 66) from 3...
January 10, 1996: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
C E Tobe, C Vocelka, R Sepulvada, B Gillis, M Nessly, E D Verrier, B O Hofer
Prior nonblinded studies have suggested dramatic hemostatic effects and decreased plasma after cardiopulmonary bypass. Platelet rich plasma (8 to 10 ml/kg total body weight) was obtained (Haemonetics Plasma Saver; Haemonetics Corp., Natick, Mass.) from 51 patients undergoing primary coronary artery bypass grafting before heparinization. After double-blinded randomization, the platelet rich plasma was reinfused immediately in the control group or after heparin reversal in the treatment group. Homologous blood product usage, blood loss, and the surgeon's intraoperative subjective assessment of coagulation were evaluated...
June 1993: Journal of Thoracic and Cardiovascular Surgery
D F Warnock, J K Davison, D C Brewster, R C Darling, W M Abbott
Intraoperative autotransfusion is a technique well-suited to major vascular surgery. It is most effective when salvage and reinfusion of shed blood can be accomplished at flow rates compatible with the degree of hemorrhage encountered in both elective and emergency procedures. Appropriate equipment modifications can render commercially available autotransfusion devices safer and more effective in the management of intraoperative blood loss. The Cell Saver, a device which concentrates and washes salvaged red blood cells, is limited in its potential as an autotransfusion device because of its slow reinfusion rate...
June 1982: American Journal of Surgery
D C Mann, M R Wilham, E M Brower, C L Nash
Blood loss and blood replacement are necessities in spinal surgery. They also have increasing risks. Three blood replacement options and combinations were investigated in patients undergoing major spinal deformity surgery. In Section 1, intraoperative replacement from harvested cell saver blood was investigated in 35 patients. This group averaged 40% (20-60%) return of the red cell mass lost intraoperatively. In Section 2, intraoperative replacement via predeposited autologous blood was investigated in 41 patients...
December 1989: Spine
M U Heim, W Mempel
The use of FFP has increased dramatically in the last few years. In the majority of cases FFP is transfused in order to provide coagulation factors. Many physicians expect to get "better" blood parameters from concomitant FFP and red blood cell (RBC) transfusions. To avoid the risk of diseases transmitted by homologous blood predeposited autologous blood is useful for elective surgical patients. Intraoperative autotransfusion by blood salvage using a Cell Saver only provides autologous RBC without plasma, so predeposited autologous plasma seems to be a necessary supplement...
April 1990: Infusionstherapie
M R McMurray, M A Birnbaum, N E Walter
Significant blood loss during total hip arthroplasty is usually unavoidable. Blood loss is even more of a problem during revision total hip arthroplasty. Using the Cell-Saver for retrieval of red blood cells to be used for autotransfusion during surgery is a safe and useful way of sparing donor blood transfusion. This is a retrospective analysis of primary and revision total hip arthroplasty cases and comparison between cases in which Cell-Saver was used versus those in which Cell-Saver was not used. Generally accepted standards to determine the need for blood transfusion, including measured serum hemoglobin and patient symptoms and vital signs, were used as guidelines in treating patients...
March 1990: Journal of Arthroplasty
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