title: Characteristics and quality of intra-operative cell salvage in paediatric scoliosis surgery.
abstract: OBJECTIVE
  To determine the haematological and microbiological characteristics of blood recovered by using a cell saver with a rigid centrifuge bowl (100ml) in paediatric scoliosis surgery and to determine whether it conforms to the standard expected in adult patients.
  
  
  METHODS
  A cross-sectional, descriptive cohort study was performed on 24 consecutive red blood cell (RBC) units recovered from the surgical field and processed by a Haemolite® 2+ (Haemonetics Corp., Braintree, MA, EE. UU.) cell saver. Data were collected regarding age, weight, surgical approach (anterior or posterior), processed shed volume and volume of autologous RBC recovered, full blood count, and blood culture obtained from the RBC concentrate, and incidence of fever after reinfusion.
  
  
  RESULTS
  The processed shed volume was very low (939±569ml) with high variability (coefficient of variation=0.6), unlike the recovered volume 129±50ml (coefficient of variation=0.38). A statistically significant correlation between the processed shed volume and recovered RBC concentrate haematocrit was found (Pearson, r=.659, P=.001). Haematological parameters in the recovered concentrate were: Hb 11±5.3g dl(-1); haematocrit: 32.1±15.4% (lower than expected); white cells 5.34±4.22×103 ul(-)1; platelets 37.88±23.5×103 ul(-1) (mean±SD). Blood culture was positive in the RBC concentrate recovered in 13 cases (54.2%) in which Staphylococcus coagulase (-) was isolated.
  
  
  CONCLUSIONS
  Cell salvage machines with rigid centrifuge bowls (including paediatric small volume) do not obtain the expected haematocrit if low volumes are processed, and therefore they are not the best choice in paediatric surgery.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, España. Electronic address: antonioperezferrer@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Perez-Ferrer
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Gredilla-Díaz
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: de Vicente-Sánchez
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Central de la Defensa Gómez Ulla, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Navarro-Suay
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, España.
authors.forename: F
authors.initials: F
authors.lastname: Gilsanz-Rodríguez
mesh_terms: D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D006400:Hematocrit; D006801:Humans; D012600:Scoliosis / Q000601:surgery*
keywords: Alternativas a la transfusión; Blood transfusion autologous; Bloodless medical and surgical procedures; Cirugía ortopédica; Escoliosis; Intraoperative blood salvage; Orthopaedic surgery; Recuperación de sangre operatoria; Scoliosis; Transfusión de sangre autóloga