EXPERIENCE WITH HAEMONETICS CELL SAVER 5+ IN OBSTERIC PRACTICE

Objective. To define the possibilities and benefits of intraoperative autoerythrocyte reinfusion (IAR) using a Haemonetics Cell Saver 5+ in massive obstetric hemorrhage and to assess IAR versus donor red blood cell transfusion. Subject and methods. One hundred and forty-nine histories of surgical deliveries accompanied by a hemorrhage volume of ≥ 2000 ml (≥ 30% of circulating blood volume) were retrospectively analyzed. The deliveries were performed at the Center for Family Planning and Reproduction, Moscow Healthcare Department, and the Moscow Perinatal Medical Center in 1997 to 2013. Group 1 consisted of 44 patients who had been transfused donor red blood cells to make up for blood loss. The other 105 puerperas had undergone IAR using a Haemonetics Cell Saver 5+. Out of them, 49 women needed additional donor red blood cell transfusion. These patients formed Group 2. Blood loss was replenished with only autoerythrocytes in 56 patients included into Group 3. Results. In Group 3 patients, infusion therapy involved a lower volume of fresh frozen plasma (p<0.0001); the duration of treatment in an intensive care unit was shortest and occasionally more than 23 hours (p<0.0001); the patients were discharged from hospital generally at 8 days postpartum (p<0.0001). These puerperas demonstrated the highest hemoglobin levels at all study time intervals (in intraoperative hemorrhage (p<0.00001), after 6 hours later (p<0.05), at days 2 (p<0.05) and 7(p<0.0001) after sustaining blood loss). Although in Group 2 the blood loss volume exceeded that in Group 1 (p<0.0001), Group 2 puerperas had higher hemoglobin levels intraoperatively, after 6 hours, and days 2 and 7 days postpartum than Group 1 ones (p<0.05). Conclusion. IAR is effective and safe in obstetric hemorrhage, can reduce the volume of transfused donor red blood cells and the duration of inpatient treatment in puerperas with sustained massive blood loss. Autoerythrocyte reinfusion using a Cell Saver may be recommended for the wide introduction into obstetric practice.

Cell Saver, hemorrhage, Cell Saver, autologous blood transfusion in obstetrics