Perioperative Blood Management: Pros and Cons of ANH and Cell Salvage

Abstract

Without doubt, allogenic blood transfusion has been an important lifesaving option in some circumstances. However, allogenic blood transfusion also has its drawbacks. Side effects of allogenic blood transfusion, blood scarcity and individual religion problem like Jehovah’s witnesses are major issues [1,2]. In this respect, there has been much effort to replace allogenic blood transfusion such as using pharmacological agent, injecting topical vasoconstrictive agent, induced hypotension, intravenous iron, erythropoietin, coagulant and so on [3]. In addition, with growing technology, Cell salvage and Acute normovolemic hemodilution (ANH) has emerged as a substitute for allogenic blood transfusion [3,4]. First, Cell salvage became widely known in the late 1970s due to the infection threat like viral hepatitis and HIV infection from allogenic blood transfusion [5]. Namely, it was introduced in an optimal time to the world. Even now, cell salvage is a useful and effective technique with a low risk of transfusion-borne infection. Second, ANH has been utilized and its efficacy studied since the 1960s [6,7]. ANH is also considered to be helpful in cutting back the volume of allogenic blood transfusion and transfusion of autologous whole blood [8]. Nonetheless, still the efficacy and utility of ANH and cell salvage is unclear with pros and cons due to inconsistent conditions among various articles and outcome from journals ranging from effectiveness to insignificance or being unthrifty when considering other facilities. Hence, through this study, we provide clinical information about procedures mentioned above, gather various articles about cell salvage and ANH and make a conclusion whether cell salvage and ANH is effective or Review