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Cell Salvage Contraindications — FRCA Final MCQ

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ModerateAnaesthetic Equipment & SafetyCell Salvage ContraindicationsFRCA Final

A 40-year-old woman (70 kg) with a history of multiple previous laparotomies and extensive adhesions is listed for further abdominal surgery. The surgeon warns of potential massive blood loss. Cell salvage is available. Which specific contraindication to cell salvage must be excluded?

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Correct answer: B — Bowel contamination of the operative field

Absolute contraindications to cell salvage include: contamination of the operative field with bowel contents (risk of bacterial contamination of salvaged blood), malignant cells in the operative field (though this is now considered a relative contraindication with leucodepletion filters), and contamination with substances toxic to red cells (betadine, hydrogen peroxide, topical haemostatic agents). Bowel contamination is the most critical exclusion. Relative contraindications include amniotic fluid (now acceptable with leucodepletion) and sickle cell disease (use of a cell washer that avoids hypotonic solutions).

Reference: Association of Anaesthetists – 2018 – Cell salvage guidelines; NICE – 2015 – NG24 Blood transfusion