title: Vancomycin added to the wash solution of the cell-saver. Effect on bacterial contamination.
abstract: OBJECTIVE
  The aim of this study is to test whether the addition of a low-dose of antibiotic (vancomycin) to the wash solution (saline) of the cell-saver reduces the incidence of bacterial contamination of the autologous red blood cell (RBCs) concentrate recovered.
  
  
  METHODS
  Experimental, randomized, double-blind, parallel group study performed on 20 consecutive patients scheduled for posterior spinal fusion surgery. Intraoperative bleeding was processed through a cell-saver: HaemoLite®2+, in which the RBCs were washed according to randomization group, with saline (control group) or saline+10μg/ml-1vancomycin (vanco group). Data regarding age, weight, processed and recovered volume, blood count, blood culture, and vancomycin concentration in RBCs concentrates obtained and incidence of fever after reinfusion were collected.
  
  
  RESULTS
  Processed volume was 843±403ml and recovered volume 121±29ml, with haemoglobin concentration 10.4±5.0g/dl-1and haematocrit 29.1±15.9% (mean±SD). Recovered RBC concentrate cultures were positive for coagulase-negative Staphylococcus in 5 cases (50%) of the control group while all cultures were negative in the vanco group (P=.016). The difference between the theoretical concentration of vancomycin administered and the concentration determined in the recovered RBC concentrate was 1.31μg/ml-1(95% CI 1.19 to 1.43; P=.074).
  
  
  CONCLUSIONS
  The addition of vancomycin at a concentration of 10ug/ml-1to the wash solution of the cell-saver achieved similar concentrations in the autologous blood concentrate recovered allowing for bacterial removal, with negative blood cultures in all cases.
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: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000517:prevention & control; D001804:Blood Transfusion, Autologous; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D006801:Humans; D007223:Infant; D057725:Operative Blood Salvage / Q000379:methods*; D012996:Solutions; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D012996:Solutions; D014640:Vancomycin
keywords: Alternativas a la transfusión; Anti-bacterial agents; Antibióticos; Autologous blood transfusion; Bloodless medical and surgical procedures; Escoliosis; Intraoperative blood salvage; Recuperación de sangre operatoria; Scoliosis; Transfusión de sangre autógena; Vancomicina; Vancomycin