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You are requested to write up about the Cell Saver. In relation to indications, contraindications, preparation, technique and components of the machine include (Introduction, Contents and images, Conclusion, references )

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CELL SAVER

Introduction: Cell saver is a device which is used in surgery. It has different prime other than getting blood transfusion from someone else. It compile or collect the blood you loss during surgery, clean the blood and return the blood back to you. Around 80% of the red blood cell the patient loss during the surgery could be return to patient.

Indication: American associated blood bank has suggested the following general indication for the cell salvage use;

Loss the 20% of the blood or more of the patient es estimate blood volume; the patient afraid to accept the allogeneic blood but we will give approval to receive blood from intraoperative cell salvage. In the population more than 10% of the patient going the procedure required transfusion. These instructions derive from cost comparison as well as very good for the economical relation.

Contraindications: It is represented that damage for patients. RBC cell could lysis and if the RBC is mixed with the sterile water, alcohol, hydrogen peroxide an so on, red cell will be distruct.

Preparations, technique and components: For the preparation the disposal equipment consist of the aspiration and centrifuge boul, waste bag, tubing and double lumen aspiration set as well as anticoagulant line which either heparin or citrate solution. The Uterine Hemorrhage is treated with the varity of technique.autologous blood transfusion technique are uses.

Presentation

Introduction:

It is very important technique through which we can collecting patient own blood lost during or after surgery. This blood could be recyle by transferring back to the same patient.

It occurs during operation, it is called intraoperative cell salvage. The patient generally loos red cell during surgery, this blood is compile or collect into a reserve or medication which is known as anticoagulation are added to the blood, which helps to stop it from clotting and clumping.

Generally red blood cells loss about 20% of the total blood cell which about 1liter of adults.

Blood collected for cell salvage should be clean which mean it should not contaminated.

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Patient Heparinized saline Dual-lumen suction catheter Saline for washing Washed RBC Reservoir Cell saver Waste products colection bag

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Conclusion: The cell salvage and autologous transfusion is the safe and active at reducing allegenica blood transfusion but also cost effective and economic supportive.

Reference:1 Blundell J.Experiments on the transfusion of blood by syringe ,Med chir, 1818, vol .9 ( pg 56-92)

2 .Brown AL, use of blood from hemothorax J.Am Med Assoc, 1931, vol.96 (pg 1223-5)

Answer 1

Cell saver is also known as intraoperative blood transfusion or autologous blood transfusion . It is a intraoperative salvage device that suction, washes, and filters blood so it can be given back to the patient instead of throwing it away.

How it works:-

Blood lost to the surgical field is collected by a dedicated suction device:

1-- Mixed with heparin or citrate (anticoagulant)

2-- Filtered to remove debris & then centrifuged to concentrate the RBC's

3-- Concentrated & washed to remove any contaminants such as anticoagulant, free Hgb, WBC's, Plasma, & platelets

4-- Diluted to final Hct of 60-70

Indication :-

Surgical procedure Valve replacement Redo bypass grafting Specialty Cardiac Orthopedics Major spine Bilateral knee replacement Revision hip replacement Radical retropubic prostatectomy Urology Cystectomy Nephrectomy Giant basilar Thoracoabdominal Neurosurgery aneurysm Vascular aoric aneurysm repair Abdominal aortic aneurysm repair Liver transplant Other Jehovah's Witnesses Unexpected massive blood loss RBC antibodies

Contraindications :-

Pharmacologic agents Clotting agents (Avitene, Surgicel, Gelfoam, etc.) Irrigating solutions (Betadine, antibiotics meant for topical use) Methylmethacrylate Contaminants Urine Bone chips Fat Bowel contents Infection Amniotic fluid Malignancy Hematologic disorders Sickle cell disease Thalassemia Miscellaneous Carbon monoxide (electrocautery smoke) Catecholamines (pheochromocytoma) Oxymetazoline (Afrin)

Cell saver Risks

-- Contamination of collected blood by urine, feces, amniotic fluid, or malignant cells

--Fever

--Non-immunogenic hemolysis

Devices used :-

# Discontinuous devices :

Haemonetics Elite and Cell Saver 5

-Medtronic Autolog

-SorinXtra

-Cobe Brat2

-DidecoCompact Advanced

# Continuous cell salvage device

-Fresenius C.A.T.S

# Advantages of cell salvage :-

- available without delay

- reduce risk of blood borne disease

- reduce blood bank need

# Disadvantages of cell salvage :-

- absolute contraindications if intestinal contamination

- it causes DIC ,if used in excess

- needs to be filtered or wash prior to pre infusion

- limit to 3000ml or less

# Benefits

Reduce requirement for allogenic transfusion by 40%, and associated risks

- TRALI

- Incompatible blood transfusion and haemolytic reactions

- Immune modulation and cancer recurrence

- Bacterial infection

- Biochemical disturbance

- Reduced 2,3 DPG

Prepation of patient preop not required

JWs may accept

Good if x-matching difficult (Abs)

Removal of activated clotting factoring and inflammatory CKs

Cells infused at room temperature

# Limitations

Initial equipment cost and maintenance cost of disposals

Staff training of complex device

Delay in processing blood and requirement of certain volume in fixed volume bowel system

Electrolyte imbalance

Air and fat embolism

Pyrexia

Infection if blood drained form infected sites

Salvaged blood syndrome: activation of coagulation and causing acute lung injury and renal failure. Assoc with fixed volume bowel system.

Haemolysis

Does not have coag factors or platelets