The cell saver is a machine which collects shed blood during surgery and centrifuges it. Since red blood cells (RBCs) are the heaviest in the blood, they sink to the bottom of the collection reservoir. The machine then separates the RBCs, anticoagulant, plasma, and platelets into two separate bags. Normal saline, 0.9%, is pumped into the system to wash the RBCs. In the end, the centrifuged and washed RBCs are transfused back into the patient.
This retrospective study was done as part of the MetroHealth Medical Center Transfusion Committee Quality Assurance. Patients receiving intraoperative cell salvage (Fresenius CATS, Bad Homburg, Germany) during general anesthesia for elective and emergency surgeries were identified from the perfusion records, and cross-referenced with anesthesia records and Epic Care.
A total of 50 patients were identified between Jan 1 and June 17, 2003. Two patients were excluded as there was insufficient blood collected. The majority of surgeries were elective (74%) in males (60%). The mean (+SD) age was 54 +18 yrs, and weight was 79 + 20 kg. Surgical services utilizing intraoperative cell salvage were orthopaedics-38%, vascular-31%, cardiothoracic-23%, and other-8%. Anesthesia records were missing for three patients. Estimated blood loss was 2.7 + 4.2 L. Average volume returned by the cell saver was 0.6 + 0.9L (Figure).
Intraoperative cell salvage is an important method to decrease the amount of RBC transfusion in this group of patients. Anesthesia personnel were able to return an average of 0.6 L of cell saver blood, which represented 22% of the overall blood loss.
The authors would like to thank Richard Kramer, Pat Dunn and perioperative anesthesia, nursing, and surgery personnel.
Figure. Volume of Cell Saver Blood Returned