A cell saver is used to manage blood loss during surgical procedures. This technology allows medical teams to conserve a patient’s own blood, reducing the reliance on donor blood and its associated risks. By collecting and preparing a patient’s blood for reinfusion, cell savers contribute to safer and more efficient medical interventions.
What a Cell Saver Is
A cell saver, also known as an intraoperative blood salvage device, is a medical device used during surgery or trauma to recover a patient’s lost blood. Its core function is autotransfusion, which involves collecting, processing, and returning the patient’s own blood rather than using blood from a donor. This process is distinct from traditional blood transfusions, which use donor blood. The primary purpose of a cell saver is to act as a blood conservation strategy, minimizing the need for external blood products. This device plays a significant role in maintaining a patient’s blood volume and oxygen delivery during procedures where substantial bleeding is anticipated or occurs.
How a Cell Saver Works
A cell saver operates through a multi-step process to ensure the recovered blood is safe for reinfusion. Initially, blood lost from the surgical site is suctioned into a sterile collection reservoir. This collected blood is immediately mixed with an anticoagulant solution to prevent it from clotting. The blood then undergoes filtration to remove impurities such as surgical debris, fat, and other contaminants.
Following filtration, the blood moves into a centrifuge, a component that spins at high speeds. This rapid spinning separates the blood components based on their density; red blood cells, being denser, collect at the bottom of the centrifuge bowl. Other components, like plasma, platelets, white blood cells, and the anticoagulant, are then washed away with a sterile saline solution and directed into a waste bag. The final product is a concentrated suspension of the patient’s own washed red blood cells in saline, which is then transferred to a bag ready for reinfusion back into the patient. This process ensures that primarily viable red blood cells are returned to the patient.
When Cell Savers Are Used
Cell savers are used when significant blood loss is expected or has occurred, allowing reinfusion of the patient’s own blood. They are common in various surgical specialties, including:
Cardiac surgeries, such as coronary artery bypass grafting and valve replacements, which often involve substantial blood loss.
Orthopedic procedures, including joint replacements and spinal fusions, due to the potential for considerable bleeding.
Vascular surgeries, which carry a high risk of blood loss.
Trauma and emergency care, where immediate blood replacement is often necessary.
Some obstetric procedures, particularly in cases of anticipated severe hemorrhage like placenta previa or placenta accreta spectrum disorders.
Factors in Cell Saver Use
The decision to use a cell saver involves several considerations. While generally beneficial, certain conditions may influence its application. An active infection in the surgical field can be a factor, as reinfusing blood potentially contaminated with bacteria is typically avoided. However, advancements in filtration technology, such as the use of leukocyte depletion filters, are being explored to mitigate this concern.
The presence of certain types of cancer can also influence the decision due to concerns about potentially reinfusing malignant cells. Although studies have shown that specialized filters can effectively remove tumor cells, the use of cell savers in cancer surgery is often determined on a case-by-case basis. Additionally, specific blood disorders, such as sickle cell disease, present considerations for cell saver use due to theoretical risks of increased sickling or hemolysis during processing. Contamination of the surgical field with substances like certain cleaning solutions, bone cement, or bowel contents also prevents the use of salvaged blood.