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Utilization of Blood Recycling in Nonelective Surgery

Utilization of Blood Recycling in Nonelective Surgery Abstract • Intraoperative infusion of autologous shed blood is efficacious in elective vascular, cardiac, and orthopedic surgery. Blood recycling has also been advocated for emergency and trauma surgery. We examined 33 candidates for autotransfusion during emergency surgery. Autologous blood accounted for only 11% of the total blood replaced. Only 25 of the patients survived long enough to permit reinfusion. Because of rapid hemostasis, nine of the remaining patients (36%) received less than the 2 units necessary to be cost-effective. No evidence was found for septicemia or coagulopathy caused by autotransfusion. We concluded that, as currently applied, recycling of shed blood during emergency surgery is of value in a limited group of patients. The collection and storage of heparinized shed blood during the preoperative and early intraoperative periods, with later processing and reinfusion in selected patients, may expand its applicability. (Arch Surg 1983;118:626-630) References 1. Messick KD, Gibbons GA, Fosburg RG, et al: Intraoperative use of the Haemonetics Cell Saver. Proceedings of the Blood Conservation Institute, Boston, 1978. 2. Umlas J, O'Neill TP: Heparin removal in an autotransfusor device . Transfusion 1981;21:70-73.Crossref 3. Orr WD, Blenko JW: Autotransfusion of concentrated selected washed red cells from the surgical field: A biochemical and physiological comparison with homologous cell transfusion. Proceedings of the Blood Conservation Institute, Boston, 1978. 4. Lonser RE, Taber B: Autologous transfusion in a community hospital. Proceedings of the Haemonetics Research Institute, Braintree, Mass, 1980. 5. Moran JM, Babka R, Silberman S, et al: Role of the Haemonetics Cell Saver following cardiopulmonary bypass. Proceedings of the Haemonetics Research Institute, Braintree, Mass, 1977. 6. Black HA, Dearing JP: Exchange transfusion prior to cardiopulmonary bypass in sickle cell anemia . JECT 1980;12:82-85. 7. Moran JM, Babka R, Silberman S, et al: Immediate centrifugation of oxygenator contents after cardiopulmonary bypass . J Thorac Cardiovasc Surg 1978;76:510-517. 8. North ER, Nelson LL, Lawson NW: Prevention of blood loss in total hip replacement surgery by hypotensive anesthesia and intraoperative autotransfusion . Surg Forum 1975;26:517-518. 9. Csencsitz TA, Flynn JC: Intraoperative blood salvage in spinal deformity surgery in children . J Fla Med Assoc 1979;66:31-34. 10. Thomas GI, Jones TW, Stavney LS, et al: Experiences with autotransfusion during abdominal aortic aneurysm resection . Am J Surg 1980; 139:628-633.Crossref 11. Mattox KL, Walker LE, Beall AC Jr, et al: Blood availability for the trauma patient: Autotransfusion . J Trauma 1975;15:663-669.Crossref 12. Duncan SE, Klebanoff G, Rogers W: A clinical experience with intraoperative autotransfusion . Ann Surg 1974;180:296-304.Crossref 13. Rumisek JD, Weddle RL: Autotransfusion in penetrating abdominal trauma , in Hauer JM, Thorer RL, Dawson RB (eds): Autotransfusion . New York, Elsevier North Holland Inc, 1981, pp 105-113. 14. Winton TL, Charrette EJP, Salerno TA: The Cell Saver during cardiac surgery: Does it save? Ann Thorac Surg 1982;33:379-381.Crossref 15. Counts RB, Haisch C, Simon TL, et al: Hemostasis in massively transfused trauma patients . Ann Surg 1979;190:91-99.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Utilization of Blood Recycling in Nonelective Surgery

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1983.01390050092018
Publisher site
See Article on Publisher Site

Abstract

Abstract • Intraoperative infusion of autologous shed blood is efficacious in elective vascular, cardiac, and orthopedic surgery. Blood recycling has also been advocated for emergency and trauma surgery. We examined 33 candidates for autotransfusion during emergency surgery. Autologous blood accounted for only 11% of the total blood replaced. Only 25 of the patients survived long enough to permit reinfusion. Because of rapid hemostasis, nine of the remaining patients (36%) received less than the 2 units necessary to be cost-effective. No evidence was found for septicemia or coagulopathy caused by autotransfusion. We concluded that, as currently applied, recycling of shed blood during emergency surgery is of value in a limited group of patients. The collection and storage of heparinized shed blood during the preoperative and early intraoperative periods, with later processing and reinfusion in selected patients, may expand its applicability. (Arch Surg 1983;118:626-630) References 1. Messick KD, Gibbons GA, Fosburg RG, et al: Intraoperative use of the Haemonetics Cell Saver. Proceedings of the Blood Conservation Institute, Boston, 1978. 2. Umlas J, O'Neill TP: Heparin removal in an autotransfusor device . Transfusion 1981;21:70-73.Crossref 3. Orr WD, Blenko JW: Autotransfusion of concentrated selected washed red cells from the surgical field: A biochemical and physiological comparison with homologous cell transfusion. Proceedings of the Blood Conservation Institute, Boston, 1978. 4. Lonser RE, Taber B: Autologous transfusion in a community hospital. Proceedings of the Haemonetics Research Institute, Braintree, Mass, 1980. 5. Moran JM, Babka R, Silberman S, et al: Role of the Haemonetics Cell Saver following cardiopulmonary bypass. Proceedings of the Haemonetics Research Institute, Braintree, Mass, 1977. 6. Black HA, Dearing JP: Exchange transfusion prior to cardiopulmonary bypass in sickle cell anemia . JECT 1980;12:82-85. 7. Moran JM, Babka R, Silberman S, et al: Immediate centrifugation of oxygenator contents after cardiopulmonary bypass . J Thorac Cardiovasc Surg 1978;76:510-517. 8. North ER, Nelson LL, Lawson NW: Prevention of blood loss in total hip replacement surgery by hypotensive anesthesia and intraoperative autotransfusion . Surg Forum 1975;26:517-518. 9. Csencsitz TA, Flynn JC: Intraoperative blood salvage in spinal deformity surgery in children . J Fla Med Assoc 1979;66:31-34. 10. Thomas GI, Jones TW, Stavney LS, et al: Experiences with autotransfusion during abdominal aortic aneurysm resection . Am J Surg 1980; 139:628-633.Crossref 11. Mattox KL, Walker LE, Beall AC Jr, et al: Blood availability for the trauma patient: Autotransfusion . J Trauma 1975;15:663-669.Crossref 12. Duncan SE, Klebanoff G, Rogers W: A clinical experience with intraoperative autotransfusion . Ann Surg 1974;180:296-304.Crossref 13. Rumisek JD, Weddle RL: Autotransfusion in penetrating abdominal trauma , in Hauer JM, Thorer RL, Dawson RB (eds): Autotransfusion . New York, Elsevier North Holland Inc, 1981, pp 105-113. 14. Winton TL, Charrette EJP, Salerno TA: The Cell Saver during cardiac surgery: Does it save? Ann Thorac Surg 1982;33:379-381.Crossref 15. Counts RB, Haisch C, Simon TL, et al: Hemostasis in massively transfused trauma patients . Ann Surg 1979;190:91-99.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: May 1, 1983

References

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