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Intra operative cell salvage in obstetrics- Our experience

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INTRA OPERATIVE CELL SALVAGE: OUR EXPERIENCE

A Amarasekara, F Choksey, P Kajekar, P Kimani, Anaesthesia, University Hospital of Coventry and Warwickshire, Coventry, UK

INTRODUCTION

The use of intra operative cell salvage in caesarean sections has become the standard practice for patients with high risk of bleeding. We describe our experience of using cell salvage in 1461 patients who had cell salvage.

METHOD

•  Date was collected prospectively for a period of 18 months. Single sucker technique was used without the use of leuco-depleton (LD) filters for re-infusion. Patients with blood loss of over a liter were studied. Logistic regression model was used for analysis. We compared the need for donor blood in patients who received cell salvage blood to those who did not.

RESULTS

Cell salvage was collected in 1461 patients. 99 (6.7%) patients had blood processed and re-transfused. None of the patients had any complications related to cell salvage. Patients who had blood loss over a liter were further analysed. The results were adjusted for pre op haemoglobin and estmated blood loss in both groups. The cell salvage re-infusion group had a  probability of 0.14 to receive donor blood. The non cell salvage re-infusion group had a probability of 0.22 to receive donor blood. 

CONCLUSION

  If we assume that donor blood receipients typically receives one unit of donor blood: for every 100 patients of cell salvage re-infusion group, 8 (22-14) donor blood units are saved.  On the other hand, if we assume that donor blood receipiets typically receives two units of donor blood, then if cell salvage blood transfusion is done, for every 100 pateents of cell salvage re-infusion group 16 (44-28) donor blood units are saved.

We also show that no complications could be attributed to the single sucker technique or to the absence of leuco-depletion filters in caesarean sections in our institute.

REFERENCES

1 AAGBIGuidelinesoncellsalvage

2.Intraopera>vebloodcellsalvageinObstetrics(IPG144)November2005

 

 

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