Composition of the blood sampled from surgical drainage after joint arthroplasty: quality of return.
BACKGROUND
The quality of blood obtained with a device for postoperative blood drainage and autotransfusion (Bellovac-ABT, Astra Tech AB) was investigated in 50 patients who underwent total hip replacement (THR) or total knee replacement (TKR) surgeries.


METHODS
The Bellovac-ABT drainage set was inserted and blood collection began after skin closure (THR) or 15 minutes after tourniquet deflation (TKR). A collecting bag stayed in place for less than 6 hours. The product was then returned after sedimentation and discard of supernatant, without anticoagulants.


RESULTS
Blood returned with the Bellovac-ABT had optimal hemoglobin levels and red blood cell (RBC) counts; the low platelet count reduced the risk of disseminated intravascular coagulation. Inertia of materials maintained acceptable values of C-reactive protein, whereas cytokines and complement split products rose rapidly. Higher concentrations of adenosine triphosphate and 2,3-diphosphoglycerate than in circulating blood suggested a normal RBC metabolism. No adverse reactions were observed in any participants.


CONCLUSIONS
Because of its simplicity and safety, the Bellovac-ABT autologous blood transfusion system is recommended in THR or TKR without joint infection or malignancy.
Sinardi
Daniele
D
Anesthetics and ICU Department, Orthopedic Institute of Southern Italy F. Scalabrino, Messina, Italy. dsinardi@tiscali.it
Marino
Anatonella
A
Chillemi
Sergio
S
Irrera
Massimo
M
Labruto
Guglielmo
G
Mondello
Epifanio
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D001772:Blood Cell Count; D001777:Blood Coagulation; D016063:Blood Loss, Surgical; D001798:Blood Proteins / Q000378:metabolism; D001800:Blood Specimen Collection / Q000295:instrumentation / Q000379:methods; D001804:Blood Transfusion, Autologous / Q000379:methods*; D003165:Complement System Proteins / Q000378:metabolism; D004322:Drainage / Q000295:instrumentation*; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood
D001798:Blood Proteins; D018836:Inflammation Mediators; D003165:Complement System Proteins; D010100:Oxygen