title: Time-related changes of collected shed blood in autologous retransfusion after total knee arthroplasty.
abstract: A prospective study was done to determine the changes in blood quality parameters of collected drainage blood in retransfusion systems at 6 and 12 h after surgery to verify whether the blood was still suitable for retransfusion purposes for an additional 6 postoperative hours beyond the so far accepted first 6-h time window after surgery. Eighty-one patients received retransfusion within the first 6 h immediately following total knee arthroplasty. Additionally, drainage blood was collected for another 6 h using the same retransfusion system. Samples for laboratory analysis were taken from both the first and second 6-h blood collection interval. Hemoglobin values increased from 9.6 to 10.4 g dl(-1) (p = 0.021). Platelet counts increased from 65,500 to 80,900 microl(-1) (p < 0.001). Leukocyte counts increased from 5,550 to 8,190 1(-1) (p < 0.001). Lactate dehydrogenase (672 U l(-1) during the first vs 651 U l(-1) during the second collection period) and free hemoglobin (71.7 mg dl(-1) vs 67.0 mg dl(-1)) did not change significantly. The potassium concentration decreased slightly from 4.33 to 4.20 mg dl(-1) (p = 0.002). The lactate concentration increased from 4.44 to 7.21 mg dl(-1) (p < 0.001). The pH decreased from 7.07 to 6.94 (p < 0.001). Interleukin-6 concentration increased from 6,500 to 46,500 ng l(-1) (p < 0.001). In this study, we found no relevant difference in most of the drainage blood quality parameters between the first 6-h collection period and the second 6-h collection with regard to its suitability for autologous retransfusion except higher interleukin-6 levels. Due to the higher interleukin concentration, a possible increase in febrile reactions should be taken into account during retransfusion.
authors.affiliation: martin_handel@freenet.de
authors.forename: M
authors.initials: M
authors.lastname: Handel
authors.forename: J
authors.initials: J
authors.lastname: Winkler
authors.forename: R F
authors.initials: RF
authors.lastname: Hörnlein
authors.forename: H
authors.initials: H
authors.lastname: Northoff
authors.forename: P
authors.initials: P
authors.lastname: Heeg
authors.forename: S
authors.initials: S
authors.lastname: Sell
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D001772:Blood Cell Count; D001804:Blood Transfusion, Autologous; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007773:Lactates / Q000097:blood; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D015850:Interleukin-6; D007773:Lactates