cell saver guideline

OBJECTIVES: There are multiple published guidelines regarding comprehensive patient blood management, centered on the three pillars of patient blood management, manage preoperative anemia, minimize blood loss, and tolerate intra/postoperative anemia. We sought to create an order set to facilitate widespread implementation of evidence-based cardiac surgery patient blood management. METHODS: Subject matter experts were consulted to translate existing guidelines and literature into a sample turnkey order set for patient blood management...

Surgical correction of craniosynostosis can involve significant blood loss. Rates of allogenic blood transfusion have been reported to approach 100%. Multiple interventions have been described to reduce blood loss and transfusion requirements. The aim of this study was to analyze various approaches over the last 4 decades to optimize blood loss and management during craniosynostosis surgery. PRISMA guidelines for systematic reviews were followed. PubMed and Cochrane database searches identified studies analyzing approaches to minimizing blood loss or transfusion rate in craniosynostosis surgery...

Aim: There is a lack of consensus on the optimal method of performing primary hip arthroplasty in obese patients and limited evidence. This article presents a series of considerations based on the authors' experiences as well as a review of the literature. Preoperative Care: In the preoperative phase, an informed consent process is recommended. Weight loss is recommended according to NHS England guidelines, and body habitus should be taken into account. When templating, steps are taken to avoid overestimating the implant size...

OBJECTIVE: Patients undergoing open cranial vault remodeling for craniosynostosis frequently experience substantial blood loss requiring blood transfusion. Multiple reports in the literature have evaluated the impact of individual blood conservation techniques on blood transfusion rates during craniosynostosis surgery. The authors engaged a multidisciplinary team and assessed the impact of input from multiple stakeholders on the evolution of a comprehensive quality improvement protocol aimed at reducing or eliminating blood transfusion in patients undergoing open surgery for craniosynostosis...

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...

BACKGROUND: Intra-operative cell salvage is not routinely used during cesarean delivery because it is not cost-effective for patients at low risk of hemorrhage and there are theoretical concerns about amniotic fluid embolism. Some guidelines recommend using leukocyte depletion filters to decrease the risk of amniotic fluid embolism before re-infusing salvaged blood, but these filters are not available in Japan. We compared the efficacy and safety of leukocyte depletion and micro-aggregate filters in combination with intra-operative cell salvage during cesarean delivery...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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)...

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...

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...

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...

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...