Blood Filters and Pumps

Abstract

Abstract Blood transfusion therapy is an integral part of the anesthetic management of patients in the setting of intraoperative acute blood loss and hemodynamic instability. While transfusion of blood products can be lifesaving, it is an intervention that has potential risks to the patient as well. Over the last several decades, the infectious risks of blood product transfusions have been significantly reduced by appropriate screening of donors and blood products. Hemolytic transfusion reactions have been reduced by more stringent guidelines to ensure the “right product gets to the right person.” The practice of leucocyte reduction of blood components has reduced the risks of febrile nonhemolytic transfusion reactions, transmission of cytomegalovirus, and platelet refractoriness, largely eliminating the need for leucocyte filters. However, it is universally recognized that microaggregates of fibrin clots and cellular debris that form when blood is stored need to be filtered out prior to administering blood products to patients. Blood transfusion sets currently available are routinely equipped with 170–200 micron filters, and the use of these filters during transfusion of all blood products except for hematopoietic precursor cells is considered “standard of care” throughout the developed world. A variety of pumps are available to help regulate the speed of infusion of blood products without inducing hemolysis, and some of these are equipped with the ability to warm the products to offset the risk of arrythmias and coagulopathy, particularly during massive blood transfusion protocols.