title: [Heparin elimination and free hemoglobin following cell separation and washing of autologous blood with Cell Saver 4].
abstract: Haemoseparation is used for recovery of autologous blood following cardiac surgery protecting patients from various hazards accompanying homologous blood transfusion. Former studies demonstrated that autotransfusion did not increase blood loss after cardiac surgery despite reduced plasma and platelets following centrifugation and washing of oxygenator content. The purpose of our study was to determine the content of heparin and unbound haemoglobin in autologous packed red cells. METHODS. 10 consenting patients undergoing cardiac surgery (table 1) were investigated. Immediately after termination of bypass blood samples were collected from the oxygenator and from autologous blood following concentration and washing with saline solution in the Haemonetics Cell-Saver 4. Contents of haemoglobin, haematocrit, heparin - with and without addition of antithrombine III - and unbound haemoglobin were analysed. RESULTS. Mean duration of extracorporeal circulation was 100.4 minutes. The oxygenators' volume averaged 2089.9 ml blood with a haemoglobin content of 6.7 g/dl and a haematocrit of 20.4%. This was reduced to 660.8 ml autologous blood with a haemoglobin content of 17.9 g/dl and a haematocrit of 57.2% (table 2). The heparin content of the oxygenator blood was 0.47 U/ml without AT III, and with AT III 0.87 U/ml. Autologous blood contained 0.009 U/ml without AT III; with AT III we measured 0.41 U/ml heparin. Unbound haemoglobin content amounted to 11.4 mg/dl in the oxygenator blood and 71.8 mg/dl in the autologous blood (table 3). CONCLUSIONS. Our results demonstrate that autologous blood following concentration and washing of the oxygenator blood with a Haemonetics Cell-Saver 4 contains heparin, but the amount of heparin is not enough to provoke bleeding after retransfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Abteilung Anaesthesiologie und Operative Intensivmedizin, Justus-Liebig-Universität Giessen.
authors.forename: D
authors.initials: D
authors.lastname: Kling
authors.forename: U
authors.initials: U
authors.lastname: Börner
authors.forename: B
authors.initials: B
authors.lastname: von Bormann
authors.forename: G
authors.initials: G
authors.lastname: Hempelmann
mesh_terms: D001781:Blood Component Removal / Q000295:instrumentation*; D001804:Blood Transfusion, Autologous / Q000295:instrumentation*; D017707:Erythrocyte Transfusion; D006331:Heart Diseases / Q000601:surgery*; D006355:Heart-Lung Machine; D006400:Hematocrit; D006452:Hemoglobinometry; D006493:Heparin / Q000493:pharmacokinetics*; D006801:Humans; D010100:Oxygen / Q000097:blood
chemical_list: D006493:Heparin; D010100:Oxygen
vernacular_title: Heparin-Elimination und freies Hämoglobin nach Zellseparation und Waschen autologen Blutes mit dem Cell-Saver 4.