Tiểu cầu được kích hoạt trong quá trình cứu hộ, nhưng đa số được loại bỏ trong quá trình này. Bạch cầu, bổ sung và kinins cũng được kích hoạt trong quá trình cứu hộ, nhưng phản ứng viêm hệ thống đã không được báo cáo là trên lâm sàng có liên quan. | Intraoperative autologous blood transfusion remain have no significant clinical effect. Platelets are activated during salvage but the majority are removed during the process. Leukocytes complement and kinins are also activated during salvage but systemic inflammatory responses have not been reported as clinically relevant. POSSIBLE CONTRAINDICATIONS Following a seminal report7 supporting this technology it now is accepted that three areas exist where the process of red cell salvage needs to be used with caution and following necessary risk-benefit analysis depending on the clinical urgency of the situation. These involve the use of red cell salvage when spilt operative blood may contain malignant cells or be heavily contaminated with bowel bacteria. Another area of caution is the use of red cell salvage when contaminated by amniotic fluid. It is accepted that in the presence of any of these preconditions cell salvage is not used unless considered necessary. The non-availability of a safe allogeneic blood supply is clearly a situation when the use of cell salvage is justified in an attempt to preserve the patient s own blood and help oxygen carriage In the UK current blood conservation recommendations promote the use of cell sal-vage8. The current drive for blood conservation is multifactorial but the most topical reason is the potential decrease in the availability of donor blood resulting from the introduction of a test for the presence of abnormal prion protein. However reduced numbers of donors is a problem that had its inception prior to the present testing concerns as the presence of HIV and other viral pathogens have also restricted the number of potential donors. It is against this backdrop that consideration of cell salvage in postpartum hemorrhage was made and the remainder of this chapter examines the use of intraoperative cell salvage during postpartum hemorrhage. Fortunately the widespread use of such devices has confirmed the safety of this process .
