Based on available clinical studies, efficacy (maximal tolerable blood loss) and effectiveness (gain in RBC mass) were calculated in a mathematical model for acute normovolemic hemodilution (ANH), intraoperative blood salvage (IBS), and preoperative autologous deposit (PAD). ANH showed no blood-saving capacity. PAD was sufficient under certain circumstances, namely when erythropoiesis is adequate, and time intervals and donated volume appropriate. Cell salvage proved most efficacious and effective.

This is a well-conducted, important study to underline the major role of cell salvage in blood management.

– Ernil Hansen