What is intraoperative cell salvage and how do modern cell salvage
Intraoperative cell salvage refers to a
procedure in which blood lost during surgery is collected and made available
for transfusion back to the same patient. Modern cell-saving devices function
by a four-step process:
Collection: Blood is suctioned from the surgical field and mixed in the suction tubing with an anticoagulant con-taining
either heparin or citrate. The suction pressures used in cell salvage systems
are low, below 100 mmHg, to avoid hemolysis of collected blood. The blood is
then passed through a filter to remove debris and stored in a canister until a
sufficient volume is present for further processing.
Concentration: The mixture of blood, anticoagulant, and irrigating solution collected by the
suction is passed into a centrifuge bowl, where the heavier red cells are
retained and the lighter elements are spun off and discarded.
A large volume of saline is passed through the centrifuge bowl, further removing the
noncellular elements and debris, leaving the red cells suspended in saline.
Reinfusion: The red cell/saline mixture is pumped from the centrifuge into a standard plastic infusion bag, which is then
available for transfusion back to the patient.
Modern cell salvage devices can process and
return a unit of blood every 3 minutes in the face of rapid bleeding.