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Blood Salvage

Intra-operative collection involves the aspiration, filtration, and reinfusion of shed blood from a clean surgical site or from an extra corporeal circuit. The equipment used for this type of blood salvage varies and may include a wash cycle to remove plasma, activated coagulation factors, and hemolyzed red cells.

Any of the following may be an indication for intraoperative collection:

  • Anticipated blood loss is >20% of the patient's estimated blood volume
  • More than 10% of patients undergoing the procedure require transfusion
  • Average transfusion requirements exceed 1 unit.

The procedure is most commonly used in cardiac or vascular surgery, orthopedic surgery, selected neurosurgeries, and for trauma patients with penetrating chest wounds.

Certain criteria must be met including:

  • Hemoglobin of 12 g/dL or greater
  • Absence of clinically significant coronary, pulmonary, renal or liver disease
  • Absence of severe hypertension
  • Absence of infection or risk of bacteremia

Contraindications are relative and a risk to benefit ratio should be determined for each use. Traditionally, blood is not collected from wounds or sites contaminated with infection, bowel contents, malignant tumor cells, or amniotic fluid. Aspiration of topical hemostatic agents, wound irrigants, and antibiotics not licensed for parenteral use should also be avoided.

Post-operative Autologous Blood Collection

Shed blood can only be transfused to the patient from which it was collected and procedures must ensure proper identification of the unit to the patient. The unit must be labeled with the patient's name, identification number, date and time of collection, expiration date and the statement "For Autologous Use Only". If it is stored in the Blood Bank, it must be handled like any other autologous unit except that disease testing may be waived. The unit should be stored at room temperature for up to 6 hours or at 1 to 6o C for up to 24 hours if storage begins within 4 hours of collection.

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