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Procedures

Cell salvage is a commonly used procedure in blood conservation. There are also some diagnostic or treatment procedures that use your blood as well.

Here are some examples of blood conservation procedures:

Cell Salvage

When blood is lost in the operating room from the surgical incision, the blood is suctioned up by a plastic tube. It then enters vacuum tubing to a machine that can best be described as a blood “washing machine,” exiting the device through tubing and into a bag. As the bag fills, it is raised up and the cleansed blood it holds is given back to the patient. This all happens within a matter of minutes. This can be done with only brief interruptions in connections and flow for a matter of seconds. Other forms of cell salvage are gravity fed instead of suction; the same principle applies with filtration and reinfusion.

Acute Normovolemic Dilution

This technique is sometimes used as a tool for the anesthesiologist and the surgeon to reduce the loss of the patient's red blood cells. It is usually used in procedures where the surgeon feels there is a potential for large blood loss, such as total hip replacement, or vascular aneurysm repair. At the beginning of the procedure, a large amount of blood is allowed to leave a vessel into tubing from the patient while at the same time a large amount of intravenous fluids is being delivered to the patient.

At all times, the patient is monitored very closely by the anesthesiologist to maintain a good blood pressure and oxygenation. During the procedure, the patient is losing diluted blood while the more concentrated fresh blood that was removed earlier has been temporarily diverted (while still connected) through circuitry and bags. Near the end of the surgical procedure, the anesthesiologist returns the attached collection of blood to the patient.

Cell Tagging

This is a test done to assist in diagnosing the location of blood flow to an object or area. A small amount of the patient’s blood is removed from a vein, mixed with a radioisotope, and reinjected into the patient so it can “illuminate” the path of the cells and watch them travel to the area of concern.

Blood Patch Procedure

This spinal procedure is done to repair or assist in repairing a small hole or tear in the membrane that acts as a sealant around the spinal space. A small amount of blood is withdrawn from a vein in the patient and is immediately injected into the area where the small hole exists. The blood is injected into a region to help clot and plug the hole that is leaking non-blood fluid around the spinal column.

Cardio Pulmonary Bypass (CPB), Hemodialysis (HD), Aphaeresis

These are external circulating devices used in the care of patients with various diseases.

  • CPB is frequently used when a patient’s heart needs to be operated on. It does the work of the patient’s heart and lungs so that these organs can be at rest during the surgical procedure.
  • HD is used to cleanse the patient’s blood of toxins when the patient’s kidneys are not able to do the job.
  • Aphaeresis is a procedure where specific parts of the patient’s blood is being filtered or replaced.

All of these techniques are done by way of venous or arterial access into the patient’s body through tubing and circulates outside the body. The tubing then returns the altered blood to the patient. These are considered "closed circuitry" procedures.

Blood removal from veins or reinserting blood drawn from patient tubing

Blood that is withdrawn for laboratory tests is disposed of after testing. If you are a patient who for personal or religious reasons would refuse a blood transfusion at any cost, the lab may use different procedures when drawing your blood to avoid any unnecessary losses. If you are hospitalized, be sure to mention to the person drawing your blood that you would like transfusion-free care so that they can flag you on an ID board in the lab. They will also notify the nursing staff to place identifiers on your chart and at the head of your bed for future lab personnel.

When patients need to have blood removed from intravenous tubing due to difficulty with vein access or frequency of draws, some patients get concerned. Blood conservation minded centers attempt to utilize devices that waste the least amount of blood possible.

You may see your bedside caregiver draw large amounts of blood and have it diverted into a chamber attached to you while they draw even more blood that is placed into a vial for the laboratory. They will then reinfuse the original blood into your body. This prevents a large amount of wasted blood, and also supplies them with a clean blood sample that is not contaminated with IV solution or medications in the line. If you are concerned about this diversion, talk to your health care representative or ask to speak to the Blood Conservation Coordinator about this procedure.