How would I establish a perioperative blood salvage program?

Abstract

Nearly one‐quarter of the nation's blood supply is transfused to surgical patients. In many institutions, blood management programs that include autotransfusion (perioperative blood salvage) have been developed to decrease the need for allogeneic transfusion in eligible surgical patients. This article reviews management concepts related to an autotransfusion service.

Intra‐operative cell salvage in cardiac surgery may increase platelet transfusion requirements: a cohort study

“…Finally, and in agreement with other authors, we found no difference between both groups in in-hospital mortality [13, 26,27]. We also found that the CS use has no impact on the rates of new onset renal impairment or infections, in line with the observed safety of the CS use by other authors [11,14].…”

“…The routine use of the CS is under continuous debate . Two recent meta‐analyses have concluded that the CS is effective in reducing transfusion needs .…”

Intraoperative cell salvage is associated with reduced postoperative blood loss and transfusion requirements in cardiac surgery: a cohort study

“…The removal of platelets (PLTs), plasma proteins, and plasmatic coagulation factors may, however, enhance postoperative bleeding and homologous RBC or fresh‐frozen plasma (FFP) transfusion . The benefits of routine cell salvage as blood conservation technique during cardiac surgery are therefore still under debate, despite the increasing attention for standardized perioperative blood salvage programs …”

Availability and safety of blood transfusion during humanitarian emergencies

“…Among the international publications are 3 instructive manuscripts in the category "How do I …?" that might be useful in the practical clinical support of blood and blood products during protracted humanitarian emergencies, provided blood and blood products are available (49)(50)(51). Natural -earthquake (n = 2), flooding (n = 4), drought (n = 1), landslide (n = 1), avalanche (n = 1), fire (n = 1) Human-made -terrorism (n = 10), war (including war in neighbouring countries) (n = 9), insurgency (n = 2), blockade (n = 2) These emergencies affect 20-100% of the community with estimated 10-85% of the injured requiring blood transfusion Need for blood transfusion has increased in all countries due to the humanitarian emergencies Type of emergencies has also changed over t he years -increasing conflicts and wars, explosions, acts of terrorism, refugees and population movements Emergencies affect both military personnel and civilians -women, men, children and old people.…”