Hanyang Med Rev.  2018 Mar;38(1):27-37. 10.7599/hmr.2018.38.1.27.

Perioperative Blood Management: Pros and Cons of ANH and Cell Salvage

• Ahn SM
• Lee JH

• KMID: 2407799
• DOI: http://doi.org/10.7599/hmr.2018.38.1.27

Abstract

Increasingly, autologous blood transfusion has been arousing concern owing to awareness of adverse effects of allogenic blood transfusion, blood shortage and patients, having religious or personal issues. With the development of medicine, Cell Salvage and Acute normovolemic hemodilution (ANH) has been proposed as an alternative to allogenic blood transfusion. This review looked at the use of ANH and cell salvage and evaluated the benefits and usefulness based on the strengths and indications. Although not consistent with all cases of ANH, there were benefits in the amount of hemorrhage and transfusion, and no supplementary plasma or platelet transfusion was needed after surgery when employing ANH. But, it showed a cutoff value only for massive bleeding surgery (at least 500 mL). In the case of cell salvage, the amount of blood transfusion was reduced in most cases and platelet or plasma transfusion was not required in most cases. When the Leukoreduction filter (LDF) was utilized, it showed the effect of removing bacterial infection or tumor cells. Nonetheless, the effectiveness and benefits for patients in certain condition of cell salvage and ANH is ambiguous with discrepancies among studies or patients. Therefore, the aim of this study is to provide clinical knowledge relative to the procedure, measure the efficacy and usefulness of peri-operative blood management mentioned above and discuss the forthcoming prospects and challenges.

Keyword

Blood transfusion; Autologous; Operative blood salvage; Hemodilution

MeSH Terms

Bacterial Infections
Blood Platelets
Blood Transfusion
Blood Transfusion, Autologous
Hemodilution
Hemorrhage
Humans
Operative Blood Salvage
Plasma
Platelet Transfusion

Figure

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  Fig. 1 Autologous blood extracted during the perioperative state as shown is contained in the transfusion bag.

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  Fig. 2 Well-known cell salvage machine: cell saver.

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