Use of Haemonetics Cell Saver for autotransfusion in cardiovascular surgery.

The Haemonetics Cell Saver was evaluated as a tool for the refining of blood shed during cardiovascular surgery. After blood filtration the red cells are concentrated, washed and re-infused as red cells suspended in normal saline (CS blood) with haematocrit around 60%. Platelets and plasma with desired and undesired components are removed. In 50 patients undergoing elective but complicated cardiovascular surgery an average of 4.4 units CS blood were produced. In 3 Jehovah's Witnesses the method was used in combination with immediate preoperative prebleeding and dextran infusion. No blood products were given. The haematocrit was maintained at a safe level subsequent to retransfusion. Platelet counts were never critically low and extremely low total protein did not lead to peripheral or pulmonary oedemas or coagulation problems. In an in vitro study it was shown that extreme dilution of coagulation factors is well tolerated before the clotting time (ACT) is affected. The Cell Saver proved to be an effective, reliable and safe device for autotransfusion of salvaged blood during cardiovascular surgery.