Thromboelastography & clotting assessment of autologous blood

  • Research type

    Research Study

  • Full title

    Does the volume of blood reinfused from a cell salvage machine alter patients clotting properties?

  • IRAS ID

    225799

  • Contact name

    Catherine Ralph

  • Contact email

    catherine.ralph@nhs.net

  • Sponsor organisation

    Royal Cornwall Hospital

  • Duration of Study in the UK

    0 years, 9 months, 17 days

  • Research summary

    During routine and emergency surgery bleeding is often inevitable. The supply of donor blood is becoming increasingly limited, and whilst the risks are low, there are still risks. Cell salvage is a commonly used technique in theatre which enables the return of a patient’s own lost red blood cells, reducing and often removing the need for donor red cells, reducing post-operative anaemia and improving outcomes. Cell salvage removes blood from the surgical site where it is mixed with heparinised saline. The aspirated fluid is pooled and then spun to separate red cells from other blood components and contaminants such as platelets, blood plasma and amniotic fluid. These washed red blood cells can be returned to the patient during or post operatively. It has been noted that up to 2 liters of cell salvaged blood does not seem to affect patients clotting ability. However, when an equivalent or smaller volume of donor blood is transfused patients clotting becomes abnormal, thus requiring additional donor blood products to correct.
    TEG is an analyser which measures the clotting abilities of whole blood, including clot speed of formation, strength and stability.
    Using a TEG machine and traditional coagulation testing we plan on studying and comparing the clotting profiles of women who undergo a cesarean section and receive cell salvaged blood. In addition to the results obtained using the TEG, coagulation screens will be performed on patient samples pre and post reinfusion of their own washed red blood cells. Furthermore, a sample of salvaged red blood cells will be taken and mixed with donor blood products in the lab and processed on the TEG, this will not be given to patients. This will be compared to donor red blood cells identifying if its red cell age, storage of donor cells or other factors that affect clotting.

  • REC name

    North West - Greater Manchester West Research Ethics Committee

  • REC reference

    17/NW/0586

  • Date of REC Opinion

    25 Oct 2017

  • REC opinion

    Further Information Favourable Opinion