Allam J, Cox M, Yentis S M
Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea and Westminster Hospital, London, UK.
Int J Obstet Anesth. 2008 Jan;17(1):37-45. doi: 10.1016/j.ijoa.2007.08.001.
The safety of cell salvage in obstetrics has been questioned because of the presumed risk of precipitating amniotic fluid embolism and, to a lesser extent, maternal alloimmunisation. For these reasons, experience in this field is limited and has lagged far behind that in other surgical specialties. There has, however, been renewed interest in its use over recent years, mainly as a result of problems associated with allogeneic blood transfusion. Our aim was to review the medical literature to ascertain the principles of cell salvage, the ability of the process to remove contaminants, and its safety profile in the obstetric setting. The search engines PubMed and Google Scholar were used and relevant articles and websites hand searched for further references. Existing cell salvage systems differ in their ability to clear contaminants and all require the addition of a leucocyte depletion filter. Although large prospective trials of cell salvage with autotransfusion in obstetrics are lacking, to date, no single serious complication leading to poor maternal outcome has been directly attributed to its use. Cell salvage in obstetrics has been endorsed by several bodies based on current evidence. Current evidence supports the use of cell salvage in obstetrics, which is likely to become increasingly commonplace, but more data are required concerning its clinical use.
由于存在引发羊水栓塞的假定风险，以及在较小程度上存在母体同种免疫的风险，产科中细胞回收的安全性受到了质疑。出于这些原因，该领域的经验有限，且远远落后于其他外科专业。然而，近年来人们对其使用重新产生了兴趣，主要是由于与异体输血相关的问题。我们的目的是回顾医学文献，以确定细胞回收的原理、该过程去除污染物的能力及其在产科环境中的安全性。使用了搜索引擎PubMed和谷歌学术，并人工搜索相关文章和网站以获取更多参考文献。现有的细胞回收系统在清除污染物的能力方面存在差异，并且都需要添加白细胞滤除器。尽管缺乏产科自体输血细胞回收的大型前瞻性试验，但迄今为止，尚未有任何直接归因于其使用的导致产妇不良结局的严重并发症。基于当前证据，几个机构已认可产科中的细胞回收。当前证据支持在产科使用细胞回收，这可能会变得越来越普遍，但关于其临床应用还需要更多数据。
