Detection and removal of fat particles from postoperative salvaged blood in orthopedic surgery

Ramirez, Gemma; Romero, Adolfo; García-Vallejo, Juan J.; Múñoz, Manuel

doi:10.1046/j.1537-2995.2002.00005.x

Cited by 42 publications

(37 citation statements)

References 39 publications

(44 reference statements)

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“…Many devices and processes have been developed to assist in salvaging the patient’s own whole blood since the 1970s, when it was popularized in major thoracic or abdominal procedures[109]. Unwashed blood revealed poor results as it may contain hemolyzed RBC, clotting factors and cytokines[110,111]. Therefore, cell separation and washing showed better results with an autologous red cell concentrate with normal function and no complications[112].…”

Section: Intra-operativementioning

confidence: 99%

Perioperative blood management strategies for patients undergoing total knee replacement: Where do we stand now?

Themistoklis¹,

Vogiatzaki²,

Kazakos³

et al. 2017

WJO

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Total knee replacement (TKR) is one of the most common surgeries over the last decade. Patients undergoing TKR are at high risk for postoperative anemia and furthermore for allogeneic blood transfusions (ABT). Complications associated with ABT including chills, rigor, fever, dyspnea, light-headedness should be early recognized in order to lead to a better prognosis. Therefore, perioperative blood management program should be adopted with main aim to reduce the risk of blood transfusion while maximizing hemoglobin simultaneously. Many blood conservation strategies have been attempted including preoperative autologous blood donation, acute normovolemic haemodilution, autologous blood transfusion, intraoperative cell saver, drain clamping, pneumatic tourniquet application, and the use of tranexamic acid. For practical and clinical reasons we will try to classify these strategies in three main stages/pillars: Pre-operative optimization, intra-operative and post-operative protocols. The aim of this work is review the strategies currently in use and reports our experience regarding the perioperative blood management strategies in TKR.

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Section: Intra-operativementioning

confidence: 99%

Perioperative blood management strategies for patients undergoing total knee replacement: Where do we stand now?

Themistoklis¹,

Vogiatzaki²,

Kazakos³

et al. 2017

WJO

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“…Very recently, we have validated a new method, far more simple and faster than the flow cytometry, based on the use of the different hematologic cytometers, that allows for detecting fat particles in USB and verifying their elimination by the use of several leukocyte filters (Pall RC100, PureCell, LeukoGuard, Sepacell, BioR, Imugard IIRC) [46,49]. Also, there is data that supports the efficiency of these filters in the elimination of tumour cells and bacteria [16,48], although other authors recommend washing and irradiating the blood [27].…”

Section: Fat Particle Content Of Usbmentioning

confidence: 99%

Transfusion of post-operative shed blood: laboratory characteristics and clinical utility

Múñoz¹,

García-Vallejo²,

Ruíz³

et al.

Haemostasis in Spine Surgery

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IntroductionIt is well known that the defence mechanisms provided by the immune system can be altered by traumatic injury, surgery and transfusions, and there is a growing interest for acquiring greater knowledge on the causes and mechanisms involved in the immunodepression induced by the anaesthetic-surgical procedure, since this increases the susceptibility to post-operative infection and tumour relapse after potentially curative surgery [15, 19,62]. This interest further increases when it is seen that, in spite of current surgical techniques, of advances in anaesthetics and in the huge variety of anti-microbial agents, general and local infection continues to be one of the main causes of morbidity-mortality associated with traumatic injuries and surgery, increasing its incidence in those patients who have received allogeneic blood transfusions (ABT) [29,61].Abstract Increased awareness of the potential hazards of allogenic blood transfusion, such as incompatibility reactions, metabolic and immunologic disorders, or transmission of viral diseases, has led to an emphasis on allogeneic blood alternatives. For orthopaedic surgery, several autologous transfusion modalities have emerged as alternatives to allogeneic blood transfusion, avoiding its immunomodulatory effects. Among them, transfusion or return of post-operative salvaged shed blood has become popular in major orthopaedic procedures. However, although the effectiveness of this blood-saving method is well documented, several authors have questioned its safety and recommended the use of washed blood. Therefore, this review analyses the haematologic characteristics of unwashed filtered shed blood, including metabolic status and survival of red blood cells, the components of the haemostatic system, the content of fat particles, bacterial and tumour cells and the possibility of their removal, the content of inflammatory mediators, and the effects on the patient's immune system. From data reviewed in this paper, it can be concluded that post-operative salvage of blood seems to be an excellent source of functional and viable red cells without many of the transfusion-related risks and with some immuno-stimulatory effects. In addition, from our experience, postoperative re-infusion of unwashed shed blood after major spine procedures has proved to reduce post-operative homologous transfusion requirements and to complement preoperative autologous blood donation, without any clinically relevant complication.

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“…When suitable wash volumes are used, activated coagulation factors, cytokines, and heparin are substantially reduced. 36,37 These complications, which have been described as the "salvaged blood syndrome," can be averted by standardizing aspiration methods, controlling saline wash volumes, and monitoring for an abnormal accumulation of debris on the inner wall of the rotating bowl. [33][34][35][36] Postoperative infusion of unwashed filtered blood has been reported to be effective and without clinically relevant complications in orthopedic patients.…”

Section: Intraoperative Salvage Of Shed Rbcsmentioning

confidence: 99%

Washed and Volume-Reduced Blood Components

Sandler¹

2007

Blood Banking and Transfusion Medicine

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Detection and removal of fat particles from postoperative salvaged blood in orthopedic surgery

Abstract: The use of the TH3 seems to be an easy, reliable, and low-cost approach for monitoring fat particle content and removal from postoperative salvaged shed blood in orthopedic procedures.

Cited by 42 publications

References 39 publications

Perioperative blood management strategies for patients undergoing total knee replacement: Where do we stand now?

Perioperative blood management strategies for patients undergoing total knee replacement: Where do we stand now?

Transfusion of post-operative shed blood: laboratory characteristics and clinical utility

Washed and Volume-Reduced Blood Components

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