Recovery of intraoperatively shed blood in aortoiliac surgery: comparison of cell washing with simple filtration.
To regain blood shed intraoperatively, two different systems are clinically established: washing and centrifuging red blood cells to produce autologous erythrocyte concentrates and devices for immediate reinfusion of whole blood after mere filtration. In a prospective-randomised study to compare both methods regarding their efficiency, adverse effects, and economy, 20 patients of our department undergoing elective aortoiliac surgery received intraoperative autotransfusion by means of either cell-washing (CS) or salvage of whole blood (WB). Patients were preoperatively randomized into one of the two groups and were evaluated with respect to standard metabolic and haematological laboratory parameters preoperatively, during surgery, after transfer into the recovery room, 24 h after surgery, after transfer into the recovery room, 24 h after surgery, and at discharge. Both patient groups were well comparable in demographics, preoperative laboratory data, and indication for operation. Handling was easier, the set-up time was shorter with the whole blood filtration device (10.2 +/- 2.3 versus 21 +/- 1.9 min, p = 0.0023), and no additional personnel was needed to run the system. The whole blood device also allowed a greater percentage of aspirated blood to be returned intraoperatively compared to cell washing (73.5% +/- 7.2 versus 51.1% +/- 6.5, p = 0.03). Thrombocytopenia occurred in 7 (CS) and 3 (WB) patients intraoperatively with a significant difference in platelet count between the two groups (118 +/- 17 [CS] versus 170 +/- 12 [WB]*10(9)/L, p = 0.025). Expected changes in the perioperative course of the clotting parameters such as highly increased PTT levels and moderately prolonged prothrombin times occurred in all cases.(ABSTRACT TRUNCATED AT 250 WORDS)
Trubel
W
W
Department of Vascular Surgery, University of Vienna, Austria.
Günen
E
E
Wuppinger
G
G
Tschernko
E
E
Günen-Frank
A
A
Staudacher
M
M
Polterauer
P
P
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D001810:Blood Volume; D003365:Costs and Cost Analysis; D017558:Elective Surgical Procedures; D017707:Erythrocyte Transfusion / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007430:Intraoperative Care; D008297:Male; D011446:Prospective Studies