The economic benefits of cell salvage in obstetric haemorrhage

Background: Cell salvage is increasingly used in the management of major obstetric haemorrhage. Its financial considerations were evaluated over a 5-year period.

Method: Cell salvage was introduced in the Liverpool Women's NHS Foundation Trust in 2006. Data were collected from all cases in which it was set-up and included the volume of blood processed and returned and whether surgery was elective or emergency.

Results: Between 1st January 2006 and 30th June 2011, cell salvage for collection was set-up 587 times and blood was returned in 137 patients. Total volume of blood returned was 47143mL, equivalent to 189 units of packed red cells. The return rate was higher for emergency than elective cases (P=0.03). As the use of cell salvage has extended over time to include a greater proportion of patients, return rates have decreased (P<0.0001). The volume of blood returned from cell salvage was significantly related to the estimated blood loss (P<0.00001), with a best fit line described by estimated blood loss=3.45x+454, where x was the volume of blood returned. In 2011 total costs of cell salvage were £9245 for the equivalent of 83 units of blood. At the current price of £125 per unit of allogeneic blood this would have cost £10375: a saving of £1130. No intraoperative or postoperative complications associated with cell salvage were seen.

Conclusion: The routine use of cell salvage was associated with more salvaged blood being returned to patients, which offset the cost of collection sets when compared to the cost of using allogeneic blood. Cell salvage is an appropriate expenditure to reduce the use of allogeneic blood.