Medical Services: Centers Of Excellence

The Institute for Patient Blood Management and Bloodless Medicine and Surgery at Englewood Hospital

Techniques: About Albumin, Blood Salvage, About Erythropoietin, About Hemoglobin-Based Oxygen Carriers (HBOCs), About Normovolemic Hemodilution

Blood Salvage

Most people are aware that bleeding, whether much or just a little, accompanies most types of surgery. There are a number of medical and surgical techniques that have been developed that make the best use of a patient’s own blood lost in surgery, though they are not available at every hospital.

Probably the best known of these techniques is the use of Intraoperative Cell Salvage, or “cell-saver” machines to collect and recycle blood lost in surgery. Basically, it works like this:  During surgery, blood that is lost into the area of surgery or the “surgical field” is collected with a suction device, the cells are gently washed with a saline type of solution and the blood is then reinfused back into the patient via an intravenous line.  The blood is never stored, and the machine is not primed with blood.  In many other hospitals, this blood lost in surgery is literally thrown away. Our philosophy, however, is that uncontaminated usable blood belongs in the patient, not in medical waste.  If a patient’s personal convictions and good medical practice allows it, this blood goes back to the patient.

We have been using this technology here at Englewood Hospital and Medical Center for many years, not just on patients for whom blood transfusion is not an option, but on any patient who is having surgery with a high anticipated blood loss.  With the use of this and other techniques, we have been able to dramatically reduce and in most cases completely eliminate even the thought of a donor blood transfusion for all our surgical patients.
There are also certain commonly performed surgical procedures which bleeding continues even after the operation has been completed.  A total knee replacement surgery is a very good example of this.  This post operative bleeding does not reflect poorly on the skill of the surgeon, rather it is just the way the body handles this type of procedure. What about this blood? Should it be discarded?

Again, if it is acceptable to the patient, a similar technique to the one described above can continue into the post operative period.  Close to the end of surgery, the surgeon can place a small tube in the area of surge and actually close the open surgical site around this tube. In the period of time immediately after the surgery, blood drains through this tube, into a machine where it is cleaned and then returned to the patient in an intravenous line. Like in cell salvage during surgery, the closed system is never broken, the blood is never stored, and the equipment is not primed with blood.  The tube is later removed with no lasting harm to the patient.

Englewood Hospital and Medical Center is proud to have invested both financial and professional resources in obtain the necessary equipment and training staff in its use.