Cell Salvage

Selected Guideline Examples Date
North Bristol Dec 2019
We Liked
  • Clear guidelines written by group who are enthusiastic regarding the use of intraoperative cell salvage in obstetrics
  • Detailed explanation of procedure
We Didn't Like
  • Rhesus sensitisation mentioned but not emphasised and do not mention other antibodies
  • Tranexamic acid not mentioned but this a requirement for use of cell salvage
  • AFE - no mention of coagulopathy or differential diagnosis (e.g anaphylaxis, sepsis)
  • Statement that IOCS enhances the safety of CS is unproven and was not outcome in the SALVO trial
Not Sure
  • Indications for use - in many units it would not be cost-effective or practical to use IOCS as routinely as this guideline would suggest. In cases where the patient does not decline blood products, IOCS often is used only for high risk surgery (e.g abnormal placentation) or when retransfusion will make a material difference to Hb levels and decrease the RBC transfusion requirement
  • References: no current references. Could highlight the JPAC UK cell salvage action group website for further information (www.transfusionguidelines.org.uk)
Other
  • All adverse transfusion events must be reported to Serious Hazards of Transfusion (SHOT)
  • Important to monitor as accurately as possible ongoing blood loss
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