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Postoperative salvage: a technological advance in the 'washed' versus 'unwashed' blood controversy
R L Tawes1, G R Sydorak, T B DuVall
1Peninsula Vascular Surgery Associates, Burlingame, CA 94010.
AT techniques are becoming the standard of care in surgery. Some controversy exists regarding the use of washed versus unwashed salvaged blood, as discussed. The literature concerning this unresolved problem has been reviewed. Because blood collected intraoperatively has undergone clotting and lysis, no beneficial coagulation effects can be expected with reinfusion of unwashed blood. If, additionally, potentially harmful effects may result, a strong argument can be made for washing the RBCs free of the activated clotting factors before reinfusion. Theoretically, this has strong appeal. In practice, it is recognized that patients who are in good health can tolerate small volume reinfusion of unwashed blood, particularly if they have been anticoagulated. In weighing the options and the risk/benefits equation, it would appear that washing the RBCs is generally the safest course. Now, it seems that there is a definite trend toward washing the red cells before reinfusion. Technological advances make this possible. The Haemolite 2 is a small, compact, portable autotransfusor that provides a safe, practical, and efficient means of recycling the patients own blood in the postoperative salvage setting.
AT techniques are becoming the standard of care in surgery. Some controversy exists regarding the use of washed versus unwashed salvaged blood, as discussed. The literature concerning this unresolved problem has been reviewed. Because blood collected intraoperatively has undergone clotting and lysis, no beneficial coagulation effects can be expected with reinfusion of unwashed blood. If, additionally, potentially harmful effects may result, a strong argument can be made for washing the RBCs free of the activated clotting factors before reinfusion. Theoretically, this has strong appeal. In practice, it is recognized that patients who are in good health can tolerate small volume reinfusion of unwashed blood, particularly if they have been anticoagulated. In weighing the options and the risk/benefits equation, it would appear that washing the RBCs is generally the safest course. Now, it seems that there is a definite trend toward washing the red cells before reinfusion. Technological advances make this possible. The Haemolite 2 is a small, compact, portable autotransfusor that provides a safe, practical, and efficient means of recycling the patients own blood in the postoperative salvage setting.
