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Intraoperative Cell salvage(ICS)

Intraoperative cell salvage (ICS) is a method of scavenging blood from the operative field, allowing it to be re-infused back into the patient. The technique involves aspirating blood lost within the surgical field into a collection reservoir. Blood is mixed with an anticoagulant solution containing either heparin or citrate to prevent clotting.

Indications for intraoperative cell salvage (ICS)

ICS systems may be used in elective and/or emergency surgical procedures where the surgical field is not contaminated by faecal or infective matter and where no other contraindications exist.
Patient selection for ICS is at the discretion of the surgeon and anaesthetist caring for the patient based on an individual risk benefit assessment.

ICS indications:

  • Patients undergoing elective or emergency surgical procedures where the anticipated blood loss is greater than 200 ml and exceeds 20% of the patient’s estimated blood volume 
  • The main indications in the paediatric population are craniosynostosis surgery, scoliosis surgery and cardiac surgery.
  • Patients undergoing elective or emergency surgical procedures who have low preoperative haemoglobin levels, where the anticipated blood loss is greater than 200 ml, and exceeds the loss required to trigger a blood transfusion
  • Patients who have rare blood groups or multiple antibodies
  • Patients who, for moral, religious or other reasons, are unwilling to receive allogeneic blood and have given their consent to receiving autologous blood collected using ICS   .
ICS contraindications

ICS should not be used when the surgical field is contaminated by bowel contents .
In the following situations ICS should usually be avoided:
  • Sickle cell trait and disease 
  • Malignant disease
  • Heparin induced thrombocytopenia or allergy to heparin

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