title: A quality assurance programme for cell salvage in cardiac surgery.
abstract: At the same time as cell salvage was introduced into our institution for all patients undergoing cardiac surgery with cardiopulmonary bypass, we established a supporting programme of quality assurance to reassure clinicians regarding safety and efficacy. Data collected in patients operated on between 2001 and 2007 included pre- and post-wash heparin concentration, haemoglobin concentration and free haemoglobin concentration. Cell salvage was used in 6826 out of a total of 7243 patients (94%). Post-wash heparin concentration was consistently low (always < 0.4 IU.ml(-1)). There was a significant decrease in post-wash haemoglobin concentration in 2003 compared to 2001, from a median (IQR [range]) of 19.6 (16.7-22.2 [12.9-25.5]) g.dl(-1) to 17.5 (13.6-20.8 [12.6-23.7]) g.dl(-1) (p < 0.015). In addition, there was a significant increase in free plasma haemoglobin in 2006 compared to 2001, from 0.5 (0.3-0.8 [0.1-2.6]) g.l(-1) to 0.8 (0.3-1.4 [0.3-5.2]) g.l(-1) (p < 0.001). This programme led to the detection of a change in operator behaviour in 2003 and progressive machine deterioration resulting in appropriate fleet replacement in 2006. You can respond to this article at http://www.anaesthesiacorrespondence.com.
authors: Department of Anaesthesia, Royal Brompton Hospital, London, UK. a.kelleher@rbht.nhs.uk
authors: A
authors: A
authors: Kelleher
authors: S
authors: S
authors: Davidson
authors: M
authors: M
authors: Gohil
authors: M
authors: M
authors: Machin
authors: P
authors: P
authors: Kimberley
authors: J
authors: J
authors: Hall
authors: W
authors: W
authors: Banya
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001804:Blood Transfusion, Autologous / Q000592:standards; D006348:Cardiac Surgical Procedures / Q000191:economics / Q000379:methods / Q000592:standards*; D003365:Costs and Cost Analysis; D017707:Erythrocyte Transfusion / Q000592:standards; D004912:Erythrocytes / Q000502:physiology; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D057725:Operative Blood Salvage / Q000191:economics / Q000592:standards*; D011785:Quality Assurance, Health Care
chemical_list: D000925:Anticoagulants; D006454:Hemoglobins; D006493:Heparin