For many years I worked as an autotransfusionist in healthcare systems throughout Michigan and Colorado. Holding a certification as a Certified Perioperative Blood Management Technician through the International Board of Blood Management, I served patients in managing their blood loss during complicated surgeries, and helped to ensure they kept as much of their own blood as possible. What does that mean, exactly? Let's go into a little detail.

What is autotransfusion?

For our purposes here, I'll be using "autotransfusion" as shorthand for "Intraoperative Autotransfusion," a Patient Blood Management (PBM) strategy in widespread use around the world. It is a procedure in which a patient's own blood is removed or salvaged from the operative field and returned to their circulation. In general practice, the patient receives back "washed" red cells after being centrifuged in a saline solution, and filtered to remove any debris or thrombocytes that may be present. The value of this practice is tremendous because it is safer and more cost-efficient than donor blood transfusion:

• There is no risk of infection or immune response

• There is no need to compatibility testing

• There is no need to wait on units from a blood bank

Beyond the immediate concerns of speed and availability, not to mention cost savings to the patient, patient blood management strategies which prevent the use of allogenic blood transfusion help to reduce the risk of postoperative complications, readmissions and mortality among patients.

Recent research from SpecialtyCare, a national surgical services provider and my former employer, found autotransfusate volume to be positively associated with increases in postoperative hematocrit. The study, based on 3225 adult cardiac procedures between February 2016 and January 2017 at 84 U.S. hospitals, revealed that a volume of blood salvaged and returned via autotransfusion during  heart surgery lead to a higher hematocrit - that is to say, a higher percentage of red blood cells in the blood. Generally, the more you have, the better. Having that elevated hematocrit helped physicians and their bedside teams reduce the need for donor blood transfusions in post-op, which is good news all around.

Have you had a procedure where autotransfusion was part of your care protocol? You might have heard it called "cell saver" - how did it work out for you? I'd love to hear about it. Email me at cwb.talk@gmail.com and let me know!