Intraoperative reinfusion of whole blood using a new autoinfusion device.
Aortic aneurysm resection is frequently associated with considerable blood loss and requires transfusion. To minimize complications and cost many institutions use a "cell saving" method that allows reinfusion of the washed red cell fraction of blood suctioned from the operative field. The disadvantages of this technique are that homologous transfusion is regularly required to replace platelets and coagulation factors. Red cell transfusion may also be required when there is rapid major blood loss as the wash cycle may be too long to subject a patient, in a high-risk group for coronary artery disease, to anaemia. A new autoinfusion device anticoagulates blood as it is suctioned from the operative field then filters, defoams, and returns it whole to the patient without a processing time lapse. We successfully used the device in a patient for aortic aneurysm resection to reinfuse two-thirds of his blood volume shed over 80 min. Neither banked red cells nor plasma were used. His haematocrit and coagulation profile remained stable throughout surgery and recovery. The potential complications and cost of homologous transfusion were avoided.
Garry
B
B
Department of Anesthesia, New England Medical Center, Boston, MA 02111.
Lisman
S
S
Wurm
W H
WH
D000925:Anticoagulants / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D001780:Blood Coagulation Tests; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001793:Blood Preservation; D001804:Blood Transfusion, Autologous / Q000295:instrumentation* / Q000379:methods*; D001810:Blood Volume; D002951:Citrates / Q000627:therapeutic use; D004867:Equipment Design; D005340:Fibrinogen / Q000032:analysis; D005947:Glucose / Q000627:therapeutic use; D006400:Hematocrit; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008851:Micropore Filters; D008875:Middle Aged; D010976:Platelet Count
D000925:Anticoagulants; D002951:Citrates; C007077:citrate phosphate dextrose; D005340:Fibrinogen; D005947:Glucose