Autologous blood collection in abdominal vascular surgery. Assessment of a low pressure blood salvage system with particular reference to the preservation of cellular elements, triglyceride, complement and bacterial content in the collected blood.

Abstract

A simple, low pressure, blood scavenging system has been assessed in major abdominal vascular operations. The aim of this study was to assess the quality of blood obtained with this device and its suitability for reinfusion. Three areas of special interest, which have not been reported so far, are the fate of plasma complement, the load of fat aspirated after tissue dissection and the degree of bacterial contamination in the scavenged blood. The development of autologous blood scavenging systems is reviewed. The features which most affect the quality of scavenged blood are identified and their importance discussed by comparison with our experience. Key features of our system were: simplicity of the apparatus, controlled low-pressure aspiration, the use of systemic heparin and the avoidance of mechanical pumps. The blood obtained was of excellent quality with good preservation of cellular elements, platelets and fibrinogen. Plasma total haemolytic complement, C3 and C4 fractions were preserved in normal, though slightly reduced, quantities. Lipid (triglyceride) content was minimally increased after filtration. Bacterial contamination was present in all cases, but at a very low level provided that aspiration was limited to the peritoneal cavity. This low-level of contamination is not thought to be of great significance; its origin and importance are discussed.