Bacteriological Methods to Monitor the Quality of Intraoperative Autotransfusion

Ezzedine, H.; Baele, Philippe

doi:10.1007/978-3-662-06119-0_21

Cited by 18 publications

(30 citation statements)

References 4 publications

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“…Our data compare well with data of Lorentz et al (1991), who reported sterile collection bags during hip surgery receiving cefuroxime prophylaxis and by Ezzedine et al (1991), who detected bacterial growth in 12% of PRBCC from patients undergoing cardiac surgery after antibiotic prophylaxis. The last step in the autotransfusion procedure comprised salvaged blood from closed wound drainages.…”

Section: Discussionsupporting

confidence: 89%

“…Several reports show that bacterial contamination of autologous blood during collection, processing or retransfusion occurs with contamination rates varying widely between 5% (Lorentz et al 1991) and 75% (Blumenberg et al 1987, Decker and Heeg 1990, Ezzedine et al 1991, Menges et al 1995, Bauermann et al 1996, Schurholz et al 1996. In our study, blood samples of 13/20 patients in the group without antibiotic prophylaxis and of 5/20 patients in the cefuroxime group were contaminated at some step in the procedure.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…One of the possible drawbacks of autologous blood transfusion is the risk of secondary contamination of the intra-and postoperatively salvaged blood (Blumenberg et al 1987, Ezzedine et al 1991, Lorentz et al 1991, Bauermann et al 1995. Several studies, however, have shown that postoperative infection rates were not increased after autologous blood transfusion (Schwieger et al 1989, Ezzedine et al 1991. Not even the salvage of blood contaminated with enteric content (Timberlake and McSwain 1988) or after bladder injury (Horst et al 1992) under emergency conditions, resulted in an increased infection rate.…”

mentioning

confidence: 99%

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Autotransfusion-bacterial contamination during hip arthroplasty and efficacy of cefuroxime prophylaxis: A randomized controlled study of 40 patients

Wollinsky

Oethinger

Büchele

et al. 1997

Acta Orthopaedica Scandinavica

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Autotransfusion-bacterial contamination during hip arthroplasty and efficacy of cefuroxime prophylaxis: A randomized controlled study of 40 patients

Wollinsky

Oethinger

Büchele

et al. 1997

Acta Orthopaedica Scandinavica

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“…On the other hand, in patients with blunt abdominal injuries, IAT seems to add little septic risk, and washed RBCs may be autotransfused without significantly increasing the incidence of infection 23 . After all abdominal surgery, close bacteriologic monitoring to detect possible bacterial contamination should be provided 24 , and potent antibiotics should be administered immediately after accidental retransfusion of contaminated shed blood. In urological operations, shed blood in the operative field will be mixed with urine and possibly contaminated with bacteria.…”

Section: Contraindicationsmentioning

confidence: 99%

Intraoperative Autotransfusion of RBC and PRP

Gombotz

Kulier

1999

Transfus Alt Transfus Med

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IntraoperativeAutotransfusion of RBC and PRP TATM 1999;3:5-13 • Intraoperative autotransfusion In addition, IP may be used when other autologous whole blood harvesting techniques are not an option. DEPARTMENT OF ANESTHESIOLOGY AND INTENSIVE CARE UNIVERSITY OF GRAZ GRAZ, AUSTRIATransfusion Alternatives in Transfusion Medicine VOLUME 1 NUMBER 3 DECEMBER 1999 Background summaryIntraoperative autotransfusion (IAT) is defined as the reinfusion of patient blood salvaged during and after surgery. IAT plays an important role in the context of perioperative blood saving strategies, having gained standard-of-care status in many surgical procedures 1,6 .The principle of IAT is to collect intraor postoperatively shed blood continuously from the operative field. The salvaged blood is aspirated from the wound site and collected in a dedicated reservoir. Under standard conditions, red cells are subsequently separated, washed, concentrated and stored for later retransfusion to the patient. Only erythrocytes are saved and retransfused; simultaneous volume and plasma replacement has to be provided, especially after processing of large quantities of shed blood 4 .In contrast to stored RBCs, freshly salvaged autologous red cells show uncompromized functional capacity, oxygen delivery to tissues and survival, indicating that IAT has no significant detrimental effects on erythrocytes 7,8 . IAT is most effective when combined with other autologous methods, particularly with preoperative autologous blood donation, acute normovolemic hemodilution or adjuvant drug therapies 4, 9, 10 . Methods Cell separation (washed blood)This technique is based on centrifugation, separating red blood cells (RBCs) from the lighter components and fluids, including plasma, saline and the buffy coat (Cell Saver, Haemolite ® , Haemonetics TM , Braintree, MA; Figure 1). Before starting the procedure, the operator must fill the system with 100-200 mL heparinized saline ("priming"), in order to prevent cells from binding to membrane surfaces initiating microaggregation, and to diminish frictional forces and damage to the cellu- Figure 1lar components 4,8 . Blood released at the wound site is aspirated via a double-lumen suction catheter (80-100 mm Hg), immediately anticoagulated (30,000 IU heparin in 1000 mL saline) at the suction tip, and stored in a plastic cardiotomy reservoir, equipped with a 120 µm microaggregate filter. When a minimum of 1000 mL shed blood is collected, it is pumped into a rotating separation chamber (Latham bowl, 225 mL adaptable capacity), washed with 1000-1500 mL saline and concentrated. Whenever the extent or kind of surgical debris requires more extensive washing, processing cycles can be selected manually, and in emergency cases, washing can be skipped entirely. For pediatric patients, smaller centrifuges are available. As soon as the preset hematocrit is reached, the spinning separator chamber stops, and packed RBCs, suspended in saline solution, are pumped into an infusion bag, while the waste products are removed 4, 11 . Afte...

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Möglichkeiten und Grenzen der intraoperativen maschinellen Autotransfusion (MAT) bei radikalen Prostatektomien

et al. 1997

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Our results showed no decrease in the quality of the autotransfused RBCs, urine was not retransfused; and there were no significant differences between the groups postoperatively. Although there were no tumour cells in the salvaged blood, the possibility of blood irradiation is discussed. We concluded that because of the risk of infection of homologous blood products, MAT is a safe possibility to reduce the amount of homologous blood transfusion required in connection with radical prostatectomy.

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Bacteriological Methods to Monitor the Quality of Intraoperative Autotransfusion

Cited by 18 publications

References 4 publications

Autotransfusion-bacterial contamination during hip arthroplasty and efficacy of cefuroxime prophylaxis: A randomized controlled study of 40 patients

Autotransfusion-bacterial contamination during hip arthroplasty and efficacy of cefuroxime prophylaxis: A randomized controlled study of 40 patients

Intraoperative Autotransfusion of RBC and PRP

Möglichkeiten und Grenzen der intraoperativen maschinellen Autotransfusion (MAT) bei radikalen Prostatektomien

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