Study of five cell salvage machines in coronary artery surgery

Abstract

We evaluated the effectiveness, ease of use and safety of five machines for blood salvage during coronary artery surgery. All were equally effective in concentrating red cells. We measured haemoglobin, packed cell volume, free haemoglobin, white cells, neutrophil elastase, platelets, thrombin-antithrombin complex (TAT), prothrombin activation peptide F1.2, fibrin degradation product (d-dimers), tissue plasminogen activator (tPA) and heparin in wound blood, in washed cell suspensions and in a unit of bank blood prepared for each patient. All machines were equally safe and easy to use and were equally effective in removing heparin and the physiological components measured. There were no adverse effects on patients. Clotting factors are severely depleted both in salvaged blood, even before washing, and in bank blood. Cell savers are a valuable adjunct to coronary artery surgery, but careful monitoring of coagulation is required when the volumes of either bank blood or salvaged blood are large.

Washing older blood units before transfusion reduces plasma iron and improves outcomes in experimental canine pneumonia

“…Washing has been shown to improve the in vitro characteristics of stored RBCs. [4][5][6][7][8][9][10][14][15][16][17] Earlier generations of cells washers were labor intensive and considered "open systems," which limited the shelf life of washed cells to 24 hours. Current microprocessor-driven, closed-system cell-washers can be programmed to provide extensive cell washing and an approved shelf life of 14 days.…”

Do repeated runs of a cell saver device increase the pro-inflammatory properties of washed blood?☆☆☆☆☆☆

“…An explanation may be that in this study only salvaged wound blood was used whereas in other studies the residual heartlung machine blood was also processed [5,6]. As in earlier studies we found a high standard deviation of IL-6 values between and in patients [1].…”

“…Recently, the quality of this washed and concentrated blood was addressed in several studies [1,5,6]. It was found that processing of shed blood by a cell saver led to normalization of some, but not all, inflammatory markers in the processed blood.…”

Coagulation and fibrinolytic protein kinetics in cardiopulmonary bypass

“…Experiments utilizing a technique for collecting, washing and concentrating blood aspirated from the operative field in a semicontinous system employing a centrifuge were conducted in the 1960s (reviewed by Burman) [88]. In addition to reducing the need for homologous transfusion, blood salvaged and washed retains 2,3-DPG concentrations ( twice the level of banked blood) and has normal oxygen-carrying capabilities.…”