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Acute Normovolemic Hemodilution (ANH)-often referred to as intraoperative hemodilution. Patients are assessed preoperatively to determine the possible effectiveness of using this method of collecting blood from the patient just prior to surgery in blood bags in a manner similar to donating at a blood center. With this technique, the anesthesiologist and the CATI perioperative blood specialist determine the amount of blood that can be safely removed and the volume expander to be used . This amount varies according to patient’s size and starting Hemoglobin. The blood withdrawn is anticoagulated, appropriately labeled by AABB standards and can be kept at the patient’s bedside for up to 8 hours. It can be given back to the patient as needed throughout or at the end of the surgical procedure. Contraindications for this are severe cardiac disease, impaired renal function, low hemoglobin and/or clotting factors.

Sequestration – Blood collected from the patient preoperatively during ANH can be separated into components of autologous red blood cells, plasma and platelets. Additionally, this is similar to provide platelet and plasma concentrations used for sealants and healing accelerants during minor and major surgical procedures.

Intraoperative Collection and Processing of Shed Blood – Blood spilled into the surgical field is retrieved by the surgeon and mixed with a medication to prevent clotting. The collected blood is filtered and then brought into a special processing bowl which separates the intact red blood cells and discards all the other fluid. The intact red blood cells are washed thoroughly to remove all medication, small clots, etc., and are placed in a blood bag which has been labeled with patient identifiers according to AABB standards. This blood is then able to be reinfused to the patient.

Postoperative Collection of Shed Blood – In certain procedures, especially total joint procedures, the surgeon may need to place a drain tube to prevent hematomas from forming. CATI specialists connect a special tubing and blood drains into a sterile collection device. Blood loss is monitored and processed for reinfusion until blood loss slows.

Growth Factor Concentration – A small amount of whole blood is collected from an intravenous port or arterial line and processed into platelet rich plasma and platelet poor plasma. These two products are used to assist in hemostasis and to accelerate wound healing. Platelets are the clotting portion of our blood system. Within them are four factors that are responsible for activating clotting patterns and inhibiting free flow of blood at the surgical site. 

Stem Cell Concentration – Once the Surgeon draws off the bone marrow from a patient, the CATI operator can spin the marrow down to become a small concentration of stem cells. These stem cells have the ability to morph into any cell of the human body. They may be used to promote bone growth or tissue growth within a surgical site.

Jehovah’s Witness - A Jehovah's Witness does not accept any type of blood bank product due to it not being their own. However, the use of cell salvage is widely accepted within the community. The patient has the option to partake in cell savage under a closed circuit system. The closed circuit system allows a continuous loop from the surgical site, through the cell saver machine, and back to the patient's intravenous site where all fluids are delivered to the patient while in the operating room. It is each own's personal preference to undergo any other CATI service such as Stem Cell Concentration or Platelet Therapy.

Veterinary Use of Platelet Rich Plasma (PRP) and Platelet Poor Plasma (PPP) – The use of PRP in veterinary medicine is evolving but has shown to be a major benefit in accelerating the healing process in animals especially horses and dogs. PRP can be injected into an injured tissue or applied topically to open wounds to facilitate faster and improved outcomes in tendon and ligament injuries.
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