Hematuria associated with low-volume cell saver in pediatric orthopaedics

A low-volume autotransfusion device, Haemocell System 350, was used for four consecutive pediatric orthopaedic patients. Although the initial patient evidenced no hematuria, transient hematuria was noted in three consecutive patients. Follow-up blood urea nitrogen, electrolytes, and creatinine levels were all within normal limits. After discontinuation of the device, no further hematuria has occurred in subsequent patients. Although intraoperative low-volume cell savers may have a role in pediatric orthopaedic surgery associated with low total blood volume loss, we observed three cases of postoperative hematuria by using this device in cases with large total blood volume loss [>28% estimated blood volume (EBV)]. Although all of these cases were transitory, we recommend caution in the use of low-volume intraoperative blood-salvage devices in pediatrics at this time.