[Rheologic and cytologic study of autologous blood collected with Cell Saver 4 during cesarean].
Intra-operative autologous transfusion has been frequently used in vascular and traumatic surgery for about ten years. The technique would be justified in other procedures when intra-operative bleeding is significant and the quality of retrieved blood is satisfactory. We have studied the potential use of intra-operative autologous transfusion during caesarean section of 15 parturients. The quality of autologous blood (at different stages of the procedure) was assessed after being recovered and washed by "Cell Saver 4" (Haemonetics). Blood quality was assessed through 1) measuring the following: erythrocyte deformability with Erythrometer and Hemorheometer; blood and plasma viscosities; ATP, 2.3 DPG and plasma hemoglobin rates; and RBC morphology through SEM; 2) bacterial detection and identification; 3) detection of foetal cells which could create immunological disturbances if reinjected into the mother. The results showed: 1) little variation in RBC deformability properties with ATP and 2.3 DPG rates which, apart from a slight decrease, remained within the normal range; 2) a 20 fold increase in plasma hemoglobin persisting, despite successive washes, in 80% of cases; 3) positive Staphylococcus epidermidis hemoculture clinically irrelevant in the reinjectable bag in 90% of cases; 4) close to 1% foetal cells in the reinjectable bag in 20% of cases; 5) 8% abnormal cells as seen on SEM (Stage I echinocytes) and a slight swelling of the RBCs, which could account for their fragility. These preliminary results show that intraoperative autologous transfusion could be used in obstetrical surgery, provided that certain precautions are taken to minimize the aforesaid drawbacks.
Centre Régional de Transfusion Sanguine, Rennes.
F
F
Durand
M
M
Duchesne-Gueguen
J Y
JY
Le Bervet
P
P
Marcorelles
R
R
Tardivel
J M
JM
Vovan
M C
MC
Le Goff
B
B
Genetet
D000328:Adult; D001769:Blood / Q000382:microbiology; D001804:Blood Transfusion, Autologous / Q000295:instrumentation* / Q000379:methods; D002585:Cesarean Section / Q000295:instrumentation* / Q000379:methods; D003581:Cytodiagnosis; D004912:Erythrocytes / Q000166:cytology; D005260:Female; D005333:Fetus / Q000166:cytology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D012212:Rheology; D014783:Viscosity
D006454:Hemoglobins
Etude rhéologique et cytologique du sang autologue recueilli par le "Cell Saver 4" au cours de césarienne.