Blood Salvage Devices

Bleeding happens during surgery. One way to replace the blood you lose during surgery is to give your lost blood back to you. To do this, a blood salvage device is used. It is a machine that collects blood during the operation. These devices are also called cell savers, because they save your own red blood cells. The device collects your blood, cleans it, and gives it back to you. The blood you receive back does not include any blood from anyone else. The risk of complications is less with your own blood compared to donor blood.

Some types of surgery involve more bleeding than others. They include operations on the heart, bones, chest, or backbone (spine). Blood salvage devices are often used for these operations.

WHEN IS BLOOD SALVAGE NEEDED?

  • When a large amount of blood loss is expected.

  • This may be because of the type of surgery, such as an operation on the heart or aorta.

  • A traumatic event, such as a car crash, may have caused a lot of blood loss.

  • If the patient could not donate blood before surgery.

  • The patient may not have been healthy enough to donate.

  • Time was short. Emergency surgery was needed.

  • Religious beliefs. Some people believe that no other person's blood should be in their bodies.

WHEN SHOULD BLOOD SALVAGE NOT BE USED?

Sometimes, using a blood salvage device may not be the best choice. This may be the case if:

  • The area of the body being operated on is infected. Using a blood salvage device could spread the infection into the blood.

  • The person has cancer. Cancer cells can be spread through the blood by using a blood salvage device. Special filters may be used to try to stop this.

  • The person has sickle cell anemia. This is a blood disease. It causes red blood cells to change shape and become sticky. Using a blood salvage device would put these bad blood cells back in the body.

  • A woman is having a cesarean birth (C-section). Using a blood salvage device could mix the baby's blood with the mother's blood. Returning this combined blood could cause an allergic reaction in the mother.

ADVANTAGES

  • Blood loss from the operation is not wasted.

  • There may be fewer risks than there are when using donated blood. The blood will not contain anything that is dangerous to you since it is your own blood.

  • Only red blood cells are replaced. That means you will not be given too much fluid.

  • The device can still collect blood from drainage tubes after surgery. It can then be cleaned and returned to your bloodstream if more blood is needed after the operation. Blood cells that are collected this way can be kept for 4 to 6 hours.

RISKS AND COMPLICATIONS

Problems are very rare. However, it is possible for things to go wrong. For example:

  • The machine could not work properly (malfunction).

  • Replacing large amounts of blood might cause problems with blood clotting. Clotting is needed to stop bleeding. When a large amount of blood is replaced, clotting might not happen as it normally does. The blood can become too "thin." This is called coagulopathy.

  • Sometimes, more blood might be needed. Your own blood would still be used, but blood from donors would also be needed.

  • Blood that is removed and stored could be misplaced or it could be switched with someone else's blood. However, caregivers are very careful when labeling and checking collection bags. This problem rarely happens.

PROCEDURE

  • Blood that pools in the area being operated on is sucked into a tube. The tube is hooked to the blood salvage machine.

  • If the machine is being used after surgery, the tubes that drain blood would be hooked to the machine.

  • A drug is added to the blood as soon as it enters the tube. This keeps it from clotting.

  • The blood flows into the machine and is filtered. This process takes out any clots. It also takes out anything bad in the blood.

  • The blood quickly goes into a spinning bowl (centrifuge). It separates the red blood cells from other parts of the blood.

  • The red blood cells are then washed. A special fluid is used to get rid of any other cells and anything else that should not be there.

  • The clean red blood cells are then infused back into your bloodstream through an intravenous (IV) access tube.