Association of Anaesthetists guidelines: cell salvage for peri‐operative blood conservation 2018

Abstract

The use of cell salvage is recommended when it can be expected to reduce the likelihood of allogeneic (donor) red cell transfusion and/or severe postoperative anaemia. We support and encourage a continued increase in the appropriate use of peri-operative cell salvage and we recommend that it should be available for immediate use 24 h a day in any hospital undertaking surgery where blood loss is a recognised potential complication (other than minor/day case procedures).

The role of intra‐operative cell salvage in patient blood management for revision hip arthroplasty: a prospective cohort study

“…Recent Association of Anaesthetists guidelines on cell salvage for peri‐operative blood conservation recommend employing cell salvage whenever anticipated blood loss exceeds 500 ml . The results of our study provide surgical teams with an estimation of intra‐operative blood loss for different revision hip arthroplasty procedures, although we recognise there may be considerable variation between patients and centres.…”

“…These findings can help allocate cell salvage when there is limited resource, which is an important barrier to widespread utilisation [8].…”

“…The odds of collecting sufficient blood were almost four times greater when the indication was an emergency revision periprosthetic fracture compared with an elective revision for an aseptic indication. These findings can help allocate cell salvage when there is limited resource, which is an important barrier to widespread utilisation .…”

“…Whilst pre-operative anaemia optimisation and antifibrinolytic therapy are indicated for all patients undergoing revision hip and knee surgery, the role of intraoperative cell salvage is less well defined [8,9].…”

Restrictive blood transfusion – is less really more?

“…Cell salvage can reduce the rate of exposure of red blood cell transfusion by a relative 38% [3]. Data on the use of tranexamic acid and whether hospitals had established patient blood management programmes are also not shown.…”