What is intraoperative cell salvage and how do modern cell salvage devices work?

What is intraoperative cell salvage and how do modern cell salvage devices work?

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.

·  Washing: 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.