Very low rate of patient-related adverse events associated with the use of intraoperative cell salvage.
The rate of patient-related clinical adverse events (AEs) associated with the use of intraoperative cell salvage (ICS) was analyzed.



The perfusion service and electronic risk management databases in a nine-hospital regional health care system were reviewed over an approximately 11-year period. The number of ICS cases performed during this period and basic patient demographics were also extracted.



There were 43,198 patients for whom ICS was utilized during the study period. Recovered blood was returned to 33,351 (77.2%) patients. Electronic comments on the ICS procedure were found in 2348 of 33,351 (7.0%) cases. The vast majority of comments (2203/2348, 93.8%) described minor events that did not lead to patient-related AEs such as the surgeon requested higher than normal suction pressure or that no RBCs were returned. Only 144 of 2348 (6.1%) of the comments described procedural or equipment-related events or potential AEs. From these comments two potential AEs were identified: the first was a post-Cesarean section patient who became acutely tachycardic, hypertensive, and dyspneic with rigors. The second was a patient with postpartum hemorrhage who experienced acute dyspnea and hypotension. Both patients were rapidly stabilized and discharged from the hospital shortly thereafter without further complications. It is unclear if these events were caused by ICS reinfusion. No air emboli were reported. The overall rate of patient-related AEs associated with ICS reinfusion was between 0 and 2 per 33,351 (0%-0.006%).



The use of ICS is safe with a very low rate of patient-related AEs.
Department of Anesthesiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
Diana
D
DeAndrade
Department of Anesthesiology, University of Pittsburgh, Pittsburgh, Pennsylvania.|Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania.
Jonathan H
0000-0001-9057-6086
JH
Waters
Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania.|The Institute for Transfusion Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Darrell J
DJ
Triulzi
Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
Louis
L
Alarcon
Donald J. Wolff Quality Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Mary Kay
MK
Wisniewski
UPMC Procirca, Pittsburgh, Pennsylvania.
Robert
R
Dyga
Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania.|The Institute for Transfusion Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Mark H
MH
Yazer
D016208:Databases, Factual; D006801:Humans; D057725:Operative Blood Salvage / Q000009:adverse effects*; D061214:Patient Safety; D010477:Perfusion / Q000009:adverse effects; D012189:Retrospective Studies