title: Processing of small volumes in blood salvage devices.
abstract: BACKGROUND
  New technical developments such as a small Latham bowl, a continuous autotransfusion system, and a dynamic disk designed for postoperative autotransfusion raise hopes for a possible application of blood salvage in young children. However, the minimal blood volume for effective processing under clinically relevant conditions has yet to be determined.
  
  
  METHODS
  Fresh blood from volunteer donations adjusted to a hematocrit (Hct) of 10% was used to test ELECTA (Sorin) equipped with a 55-mL bowl, C.A.T.S (Fresenius) in the pediatric program mode, and OrthoPAT (Haemonetics). Twenty-milliliter portions of red blood cells (RBCs) were added and processed under various conditions, including clinically relevant first filling and intermittent emptying. RBC recovery and availability and plasma elimination were calculated from the Hct, free hemoglobin, and total protein.
  
  
  RESULTS
  The main impediment to recovery and availability was the first filling. There, RBC recovery was significantly reduced, while it subsequently varied between 93 and 98%. To produce the first 30 mL of RBCs, ELECTA required 42 mL and C.A.T.S and OrthoPAT 62 mL owing to the dead space of the separation chamber or reservoir, respectively. RBC availability was much higher in subsequent processes, with only minimal differences between the three devices. They all consistently provided high plasma elimination rates.
  
  
  CONCLUSIONS
  The continuous system showed no advantage over a small Latham bowl. From the results it can be calculated that the limit for feasible cell salvage at present is an infant of 6 months. All three devices are suitable for the processing of small volumes, but have the scope for further optimization.
authors: Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany.
authors: Timo
authors: T
authors: Seyfried
authors: Anita
authors: A
authors: Breu
authors: Michael
authors: M
authors: Gruber
authors: Julia
authors: J
authors: Reipert
authors: Ernil
authors: E
authors: Hansen
mesh_terms: D016063:Blood Loss, Surgical; D001798:Blood Proteins; D001804:Blood Transfusion, Autologous / Q000295:instrumentation* / Q000379:methods*; D001810:Blood Volume; D002648:Child; D002675:Child, Preschool; D004912:Erythrocytes / Q000166:cytology; D006400:Hematocrit; D006454:Hemoglobins; D006801:Humans; D008954:Models, Biological; D057725:Operative Blood Salvage / Q000295:instrumentation* / Q000379:methods*
chemical_list: D001798:Blood Proteins; D006454:Hemoglobins