Blood recycling technology is a technique that utilizes a blood recycling machine to collect the patient’s intraoperative effluent, filter it, separate it, clean it, purify it, and then infuse it back into the patient. Blood recovery technology has been widely implemented in our hospital. If this item is included in your billing program, you can have a preliminary understanding through this article. Working Principle The blood recycling machine collects trauma bleeding or intraoperative bleeding into the blood reservoir through negative pressure absorbing device, mixes with appropriate amount of anticoagulant in the process of attraction, separates the cells after multi-layer filtration and then uses the high-speed centrifugal blood recycling tank, shunts the waste liquid, broken cells and harmful components into the waste liquid bag, cleans, purifies and concentrates the blood cells with physiological saline, and then finally, the pure and concentrated Finally, the pure and concentrated blood cells are kept in the blood bag and transfused back to the patients. Significance At present, BST has been widely used in Europe, America, Japan and other developed countries. In China, large hospitals are also gradually developing this technology. Due to the high incidence of hepatitis in China and the increasing incidence of AIDS, there is a higher possibility that the stocked blood carries the corresponding virus. At the same time, due to the tension of blood source, the contradiction of blood use in hospitals is becoming more and more prominent. In order to solve the problem of blood source and reduce the infectious diseases caused by blood transfusion, it is of great significance to vigorously promote autologous blood recovery to minimize the input of allogeneic blood. Advantages It can provide fully compatible, room-temperature homogeneous blood in a timely manner, alleviate blood tension, and virtually eliminate the risk of infection with HBV, HCV, HIV and other viruses due to allogeneic blood transfusion. Fever, allergic hemolysis and graft-versus-host reaction, which are common in allogeneic blood transfusion, are greatly reduced. Allogeneic blood transfusion can lead to immunosuppression, causing postoperative tumor recurrence and increased infection rate; the immunosuppression caused by autologous blood transfusion is much smaller. Therefore, autologous blood transfusion can be used for patients with multiple alloantibodies. The ATP and 2,3-DPG content of erythrocytes in the recovered autologous blood is higher than that of the reservoir blood, which has a better oxygen-carrying function. Autologous blood transfusion also avoids hyperkalemia, hypokalemia and acid replacement caused by allogeneic transfusion. Autologous blood transfusion usually does not require transfer for mating and disease testing, avoiding errors during these operations. Indications Trauma surgery, such as large vessel injury, bleeding from battle wounds, liver and spleen rupture, spinal trauma, and ectopic pregnancy hemorrhage. Cardiovascular surgery, major orthopedic surgery, urologic hemorrhage surgery, liver and spleen surgery, portal hypertension shunt and some brain surgery. Organ transplantation surgery. Patients who are not transfused with allogeneic blood due to special blood type, religious beliefs, etc. Postoperative uncontaminated drained blood can be recovered. The new blood recycling machine can also be used for cesarean section surgery. (Can remove amniotic fluid in the presence of functionally activated tissue factor) Contraindications Many of the contraindications are relative, and risk/benefit factors must be determined for each patient. For perioperative BST It is the responsibility of the supervising surgeon, anesthesiologist, and transfusion technician. Malignant tumors. Theoretically BST may cause hematogenous dissemination of tumors, but recent studies have shown that it does not increase their hematogenous dissemination and is feasible for use in malignancies. (It can be used with a dose of 50Gy radiotherapy can kill tumor cells) Contamination. It can be used to save lives in emergency situations of hemorrhage. BST should be discontinued in patients using collagen hemostatic substances, whose activation of platelets increases local hemostasis. Less likely to be used in HIV and hepatitis B patients. For operators there is a chance of contamination. Open trauma >4h or non-open trauma in the body cavity >6h of accumulated blood, there is a risk of hemolysis and contamination, can not be recovered. The patient is in poor general condition such as hepatic or renal insufficiency. The presence of amniotic fluid in the blood is not an absolute contraindication to BST, but it needs to be filtered with a leukocyte filter. Impact Autologous blood transfusion significantly reduces allogeneic transfusion in surgical patients. Various complications such as hemoglobinuria, cardiopulmonary dysfunction, coagulation disorders, air embolism, and severe infections are rare when smaller inputs are used. Since autologous blood does not contain coagulation factors, plasma proteins and platelets, dilutional coagulation dysfunction such as prolonged PT can occur after large volume transfusion of autologous blood, requiring simultaneous transfusion of fresh plasma, and even supplementation of platelets and coagulation factors (whose > 30% coagulation can be normalized) in order to avoid coagulation disorders that can lead to large amounts of postoperative blood seepage. Autologous blood is usually washed with NS, so the Na+ and Cl- content is high, and large amounts of washed red blood cells may have a certain impact on the internal environment. Therefore, when large amounts of autologous blood are transfused, attention should be paid to monitoring the patient’s pH and electrolyte changes. Potency ratio The potency ratio of BST is an important factor in determining whether it can be universally applied. BST is necessary when the volume of blood transfused exceeds 500 ml.The greater the intraoperative blood loss, the greater the benefit of using BST. When blood loss is less than 500 ml, many patients do not require transfusion at all, and those who do may be able to avoid allogeneic transfusion through other blood transfusion modalities, such as preoperative stored autologous transfusion and acute isovolumic hemodilution. The latter two have certain requirements on the patient’s physical condition and limitations on the amount of blood to be collected; while BST is more expensive, but has greater advantages in procedures with more bleeding. Precautions Intraoperative processed blood should not be transferred to other patients. After autologous blood is washed, platelets, coagulation factors and plasma proteins are basically lost, so they should be replenished according to the amount of recovered blood or bleeding. If the intraoperative rapid recovery processed blood is not washed and processed, it contains anticoagulant, so the corresponding antagonist should be given according to the dose of anticoagulant used. If hemoglobin remains in the intraoperative retrieved blood (especially the blood processed by rapid retrieval), appropriate treatment should be given according to the amount of hemoglobin remaining. Intraoperative retrieval operations should strictly implement the aseptic operation standard, especially the manual retrieval operation. When transfusing intraoperatively processed blood, a transfusion device must be used.