Postoperative autotransfusion: an overview of techniques and clinical efficacy.

In summary, the purpose of this discussion has been to provide an overview of the theoretical, technical and clinical nursing considerations in the use of postoperative autotransfusion. The relative safety and efficacy of utilizing autotransfusion techniques following cardiac surgery has been reported by many researchers. However, there remains other aspects and considerations in the use of autotransfusion that require further clarification. The limited documentation on the reported number of positive bacteriological cultures with open system and the associated risks of systemic sepsis warrants additional investigation. The comparative risk of sepsis between the open and closed systems requires more extensive evaluation. Another aspect of the technique that remains unestablished is the period of time that an autotransfusion system remains effective in replenishing red cell mass. This is apparent in the reported variations in time frames that have been described with the use of this technique. Protocol comparisons among various institutions that employ this technique might yield significant information about this variation. Concerns associated with the risks and cost of homologous blood products have been firmly established. The hazard of AIDS contamination secondary to blood transfusion, although remote, is often foremost in the patient's perception of risks associated with expectant surgery. Nurses have a vital role to play in providing patients with information on current medical treatment modalities, and can thereby potentially reduce preoperative anxiety. Furthermore, the education of nurses on the technique of postoperative autotransfusion provides them with the capability to safely utilize this valuable technology in patient care.