Intraoperative blood salvage: medical controversies.
Although a great deal has been learned about the medical aspects of intraoperative blood salvage, several fundamental medical issues remain controversial. As pressure increases to maximize the use of IBS, more research will be needed on the application of salvage techniques in cancer surgery and in the presence of bacterial contamination. The reintroduction of the use of devices that do not wash salvaged blood have reopened investigations into the effects of reinfusion of partially hemolyzed and partially clotted salvaged blood on coagulation, renal function, and cardiopulmonary performance. More studies are also needed so that empirically based standards of practice for the collection and storage of salvaged blood can be established. No longer confined to a few pioneering surgical departments, IBS is now widely practiced and likely to continue to grow rapidly. Knowledge and research of the medical issues surrounding its use will become increasingly valuable in transfusion medicine.
Dzik
W H
WH
Department of Pathology, New England Deaconess Hospital, Boston, MA 02215.
Sherburne
B
B
D000818:Animals; D001778:Blood Coagulation Disorders / Q000209:etiology; D016063:Blood Loss, Surgical; D001793:Blood Preservation; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D000075202:Contraindications; D004285:Dogs; D064420:Drug-Related Side Effects and Adverse Reactions; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005720:Gamma Rays; D006454:Hemoglobins / Q000633:toxicity; D006801:Humans; D015994:Incidence; D007430:Intraoperative Care; D007674:Kidney Diseases / Q000209:etiology / Q000517:prevention & control; D008546:Melanoma, Experimental / Q000097:blood / Q000556:secondary; D051379:Mice; D008810:Mice, Inbred C57BL; D009362:Neoplasm Metastasis; D009368:Neoplasm Transplantation; D009369:Neoplasms / Q000097:blood / Q000601:surgery; D009360:Neoplastic Cells, Circulating / Q000528:radiation effects; D011323:Primates; D012189:Retrospective Studies; D012306:Risk; D018805:Sepsis / Q000209:etiology / Q000517:prevention & control; D012769:Shock / Q000150:complications / Q000628:therapy; D065227:Transfusion Reaction
D005338:Fibrin Fibrinogen Degradation Products; D006454:Hemoglobins