P/N 53063-50, Manual Revision: B
Safety and Patient Care Precautions
3-7
Depletion
of Clotting
Factors
Warning: Washed, concentrated cells are depleted of clotting factors. The
physician must monitor the quantity of washed cells returned to the patient, and
supplement the washed, concentrated cells with fresh frozen plasma and
platelets if required for hemostasis.
Contraindications
for Use
The risk/benefit ratio of blood salvage must be determined on an individual basis
by the surgeons, anesthesiologists and transfusion medicine specialists involved
in the patient’s care. Refer to Appendix A for a chart of substances, effects, and
recommended actions.
Warning: The use of reinfused blood from the Cell Saver 5+ System may be
contraindicated, for example, in the case of sepsis or malignancy. The
responsibility for the use of this device belongs solely to the physician in charge.
Anticoagulant
Use
Anticoagulant solutions are added to salvaged blood to keep it from clotting.
Different anticoagulants affect the clotting process in different ways. The most
common anticoagulant solution is 30,000 units of heparin in 1L of normal saline.
This should be delivered at a 1:7 ratio of heparinized saline to blood entering the
reservoir by adjusting the roller clamp on the anticoagulant line. Citrate solution
can also be used as an anticoagulant solution. A general guide for citrate solution
delivery is a ratio between 1:5 and 1:10 anticoagulant to blood. The rate for both
anticoagulants should be set to give approximately 15 ml of anticoagulant for
each 100 ml of blood collected. A drip rate of one drop per second is generally
adequate.
