Thursday, 23 October 2008

Cell salvage

2 options for autologous transfusion

1.Chronic Isovolaemic haemodilution
Preop blood conservation

2.redcell salvage-fresh oxygenated cells

Why centrifuge blood after collection?
Red cells heavier but heparin isn't
No need for storage

How to collect blood?
*Suck from pool of blood /low pressure suction is preferrable
*No compatibility testing is necessary
*Clean operative field

Obstetrics cell salvage
1-AFE risk
2-Rh incompatiblity-fetal redcells

Cell salvage in malignancy-risk of retransfusion of malignant cells.

NICE guideline intraoperative cell salvage in Obstetrics
Incident reporting
Placenta previa/accreta
Poor quality trials
Leucocyte filters doesn't remove all the fetal squames but is this is not important as fetal sqaumes aren't implicated in amniotic fluid embolism

Rh mismatch-Kleinaugher/Anti-D

Leucocyte depletion filter is negatively charged.It
also take out fetal squames&Bacteria

Amniotic fluid components-soluble components removed by washing
-solid components by filter

1-when to iniate salvage-whether to leave the liquor out
2-Lecocyte filter associated hypotension
3-volume of washing-how much
4-leucocyte filter takes time

Malignant cells in vitro tests to detect malignant cells & viability in collected blood

Leucocyte filter-450 ml capacity/slow delivery/can become saturated/needs
Experienced staff