The quality of autotransfused chest-drainage blood after cardiac surgery: a study of coagulation factors.
A wide range of experience, dating back as far as 1978, has been gained with both the hard-shell cardiotomy reservoir of the heart-lung machine and the Sorensen autotransfusion system as retransfusion systems. Three remains, however, a lack of knowledge regarding the quality of retransfused blood in systems of less complex construction which are already available on the market and involve the use of a pouch (Sentinel-Seal autotransfusion system and Pleur-evac collecting system). The present study entailed the investigation of blood from the chest drainages of twenty patients after cardiac surgery by using a simple retransfusion system (Sentinel-Seal autotransfusion system). In two postoperative groups of patients with low and high blood loss from chest drainage, we determined, in addition to free plasma hemoglobin, the following: factor XII, kallikrein-like activity, thrombin-antithrombin III complex, tissue-plasminogen and d-dimers. In the collective with a low blood loss, we found remarkable cell alterations as well as highly activated and advanced coagulation and an extraordinary fibrinolytic activity. If done at all, retransfusion by the Sentinel-Seal autotransfusion system should be restricted to the first four postoperative hours in cases of high blood loss.
Schulze
H J
HJ
Department of Thoracic and Cardiovascular Surgery, University of Tübingen, Germany.
Wendel
H P
HP
Khalighi
K
K
Heller
W
W
Seboldt
H
H
D000990:Antithrombin III / Q000032:analysis; D001777:Blood Coagulation; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000295:instrumentation; D006348:Cardiac Surgical Procedures; D004322:Drainage / Q000295:instrumentation; D005174:Factor XII / Q000032:analysis; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006461:Hemolysis; D006801:Humans; D007432:Intraoperative Period; D007610:Kallikreins / Q000032:analysis; D019272:Leukocyte Elastase / Q000097:blood; D010447:Peptide Hydrolases / Q000032:analysis; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000032:analysis
D005338:Fibrin Fibrinogen Degradation Products; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; D000990:Antithrombin III; D005174:Factor XII; D010447:Peptide Hydrolases; D007610:Kallikreins; D019272:Leukocyte Elastase; D010959:Tissue Plasminogen Activator