Effects of unprocessed and processed cardiopulmonary bypass blood retransfused into patients after cardiac surgery.
BACKGROUND
The aim of this prospective study was to compare the effect of autologous unprocessed to processed residual cardiopulmonary bypass blood (CPB) on patients' laboratory and clinical parameters and outcome.


METHODS
20 patients undergoing elective coronary artery bypass surgery were randomized to receive either unprocessed CPB blood (control group) or processed CPB blood employing the Continuous AutoTransfusion System (CATS; Fresenius, Bad Homburg, Germany). We have shown that this method eliminated >93% of activated mediators. Serial laboratory parameters including complement activation, coagulation factors and the stimulation of IL-6 and IL-8 were compared with clinical side effects and patients' outcome.


RESULTS
Compared to control patients, retransfusion of unprocessed CBP blood significantly increased heparin, free plasma hemoglobin and D-Dimers. Postoperatively, three patients in the control group and two patients in the CATS group required prolonged mechanical ventilation or developed infections associated respectively with elevated C3a (desArg) or IL-6 concentration.


CONCLUSIONS
CATS-processing of CPB blood provided a high-quality red blood cell concentrate, resulting in a reduced load of retransfused activated mediators.
Walpoth
B H
BH
Department of Cardiovascular Surgery, Anesthesiology, Central Hematology Laboratory, University Hospital, Insel, Berne, Switzerland. beat.walpoth@insel.ch
Eggensperger
N
N
Hauser
S P
SP
Neidhart
P
P
Kurt
G
G
Spaeth
P J
PJ
Althaus
U
U
D001779:Blood Coagulation Factors / Q000032:analysis; D001804:Blood Transfusion, Autologous / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D003167:Complement Activation; D015926:Complement C3a / Q000032:analysis; D001026:Coronary Artery Bypass; D017558:Elective Surgical Procedures; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006493:Heparin / Q000097:blood; D006801:Humans; D007239:Infections / Q000209:etiology; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012121:Respiration, Artificial
D001779:Blood Coagulation Factors; D006454:Hemoglobins; D015850:Interleukin-6; D016209:Interleukin-8; D015926:Complement C3a; D006493:Heparin