Yawn D H
Baylor College of Medicine, Houston, TX.
Perfusion. 1990;5(Suppl):31-7. doi: 10.1177/0267659190005001s06.
Intraoperative blood salvage produces safe and clinically effective red cells. Intraoperative salvage for cardiovascular surgery procedures can be expected to cause a substantial reduction in the use of homologous red cells in patients requiring redo operations, and repair of complex aortic aneurysms. The procedure per se will have very little impact on the use of other blood components such as platelets or plasma. For carefully selected patients, autologous perioperative or intraoperative collection of these components should also be considered. The primary risks of intraoperative blood transfusion include washout of clotting proteins and platelets, infusion of undesirable constituents (such as antibiotics and haemostatic agents added during the surgical procedure) and air embolism. Intraoperative autologous transfusion is only one part of an effective programme to minimize homologous transfusion. Equally important is the use of preoperatively donated blood, the use of effective and safe pharmacological agents to enhance haemostasis and haematopoiesis, a conservative approach that allows only the transfusion of blood components absolutely necessary, and, when possible, the elimination of anticoagulant and antiplatelet therapy several days prior to the cardiovascular surgical procedure.
术中血液回收可产生安全且临床有效的红细胞。对于需要再次手术以及修复复杂主动脉瘤的患者，预计心血管手术中的术中回收可大幅减少同源红细胞的使用。该操作本身对血小板或血浆等其他血液成分的使用影响很小。对于经过精心挑选的患者，也应考虑自体围手术期或术中采集这些成分。术中输血的主要风险包括凝血蛋白和血小板的冲洗、不良成分的输注（如手术过程中添加的抗生素和止血剂）以及空气栓塞。术中自体输血只是将同源输血降至最低的有效方案的一部分。同样重要的是术前献血的使用、使用有效且安全的药物增强止血和造血功能、采取仅在绝对必要时才输注血液成分的保守方法，以及在可能的情况下，在心血管手术前几天停用抗凝和抗血小板治疗。
