An Update on Perioperative Blood Salvage in Cardiac Surgery

Abstract

SUMMARYBlood conservation technologies are now the subject of increasing scrutiny in cardiovascular surgical care. In particular, positive outcomes in previous trials related to the collection and reinfusion of blood collected from the surgical wound (cell salvage) have now led this latter strategy to become a key component in modern surgical practice. Although intuitively attractive, there are, however, potential drawbacks relating to its usage including the risks of induced coagulopathy, infection and hemolysis. In this review, the principles and mechanics of cell salvage (processed, i.e. centrifugally washed, and unprocessed) as they relate to cardiac surgery, will be discussed. The impact of these techniques on the quality of harvested blood will be reviewed. Finally, the efficacy of this technology as a blood conservation strategy to limit the need for homologous transfusion as demonstrated in randomized clinical trials in cardiac surgery will be reviewed.