Anaes · Perioperative medicine
Intraoperative cell salvage
Also known as ICS cell saver · Autologous blood salvage · AAGBI cell salvage
Exam-pass intraoperative cell salvage: indications, wash pathway, contraindications, obstetrics/malignancy nuances, coagulopathy after wash, and PBM integration.
Practise this topic
On this page
Study tools
Your progress
Saved on this device.
Target exams
Red flags
- Salvage returns washed RBCs — not platelets or factors.
- Wrong suction/anticoagulant wrecks quality.
- Respect refusal of autologous reinfusion if documented.
- Active bacterial contamination is a major caution.
- Air embolism and clamp errors are process failures.
Meet the patient
A 68-year-old woman is listed for a revision total hip replacement. She is one of Jehovah's Witnesses and will accept a continuous-circuit cell saver but will not accept bank blood. Expected loss is well over a litre, so the machine is not a convenience — it is the margin between a safe operation and a dangerous one.[1]
Two questions decide every cell-salvage stem: when do I set it up? — before the blood is on the floor, whenever loss or refusal makes allogeneic transfusion likely — and what actually comes back? — washed autologous red cells, and nothing else. Hold those two and the whole topic arranges itself.[1][2]
References3ShowHide
- [1]Klein AA, Bailey CR, Charlton AJ, et al. Association of Anaesthetists guidelines: cell salvage for peri-operative blood conservation 2018 Anaesthesia, 2018.PMID 29989144
- [2]Ashworth A, Klein AA Cell salvage as part of a blood conservation strategy in anaesthesia Br J Anaesth, 2010.PMID 20802228
- [3]Mazer CD, Whitlock RP, Fergusson DA, et al. Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery N Engl J Med, 2017.PMID 29130845