학술논문
Current concepts in the use of cell salvage in obstetrics.
Document Type
Academic Journal
Author
Neef V; Goethe University Frankfurt, University Hospital, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy.; Meybohm P; University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany.; Zacharowski K; Goethe University Frankfurt, University Hospital, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy.; Kranke P; University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany.
Source
Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8813436 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-6500 (Electronic) Linking ISSN: 09527907 NLM ISO Abbreviation: Curr Opin Anaesthesiol Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose of Review: The worldwide leading cause of maternal death is severe maternal hemorrhage. Maternal hemorrhage can be profound leading to an entire loss of blood volume. In the past two decades, Patient Blood Management has evolved to improve patient's care and safety. In surgeries with increased blood loss exceeding 500 ml, the use of cell salvage is strongly recommended in order to preserve the patient's own blood volume and to minimize the need for allogeneic red blood cell (RBC) transfusion. In this review, recent evidence and controversies of the use of cell salvage in obstetrics are discussed.
Recent Findings: Numerous medical societies as well as national and international guidelines recommend the use of cell salvage during maternal hemorrhage.
Summary: Intraoperative cell salvage is a strategy to maintain the patient's own blood volume and decrease the need for allogeneic RBC transfusion. Historically, cell salvage has been avoided in the obstetric population due to concerns of iatrogenic amniotic fluid embolism (AFE) or induction of maternal alloimmunization. However, no definite case of AFE has been reported so far. Cell salvage is strongly recommended and cost-effective in patients with predictably high rates of blood loss and RBC transfusion, such as women with placenta accreta spectrum disorder. However, in order to ensure sufficient practical experience in a multiprofessional obstetric setting, liberal use of cell salvage appears advisable.
(Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Recent Findings: Numerous medical societies as well as national and international guidelines recommend the use of cell salvage during maternal hemorrhage.
Summary: Intraoperative cell salvage is a strategy to maintain the patient's own blood volume and decrease the need for allogeneic RBC transfusion. Historically, cell salvage has been avoided in the obstetric population due to concerns of iatrogenic amniotic fluid embolism (AFE) or induction of maternal alloimmunization. However, no definite case of AFE has been reported so far. Cell salvage is strongly recommended and cost-effective in patients with predictably high rates of blood loss and RBC transfusion, such as women with placenta accreta spectrum disorder. However, in order to ensure sufficient practical experience in a multiprofessional obstetric setting, liberal use of cell salvage appears advisable.
(Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)