Modification of the Haemonetics Cell Saver for optional high flow rate autotransfusion.

Intraoperative autotransfusion is a technique well-suited to major vascular surgery. It is most effective when salvage and reinfusion of shed blood can be accomplished at flow rates compatible with the degree of hemorrhage encountered in both elective and emergency procedures. Appropriate equipment modifications can render commercially available autotransfusion devices safer and more effective in the management of intraoperative blood loss. The Cell Saver, a device which concentrates and washes salvaged red blood cells, is limited in its potential as an autotransfusion device because of its slow reinfusion rate. A modification was devised which expands the flow capabilities of the Cell Saver and allows rapid reinfusion of autologous whole blood. The modified blood circuit has been employed in 10 major vascular cases with favorable results, thus demonstrating its efficacy in the management of massive hemorrhage during vascular repair. Guidelines for the safe and effective use of the modified unit are stressed.