[Evaluation of the OrthoPAT autologous transfusion system by experimental models simulating intra- and postoperative blood salvage].
OBJECTIVE
To evaluate the efficacy of the OrthoPAT (Haemonetics) system for blood salvage and for removing chemical or cellular debris, by experimental models simulating intra- and postoperative conditions.


METHODS
Blood samples (20%-25% packed red cells) were prepared for the intraoperative model (n=8) and the postoperative model (n=22). Surgical compresses were soaked in some samples (n=5). Other samples were supplemented with hemolyzed blood (n=7). From others cytokines were removed and blood activated with bacterial liposaccharides (n=10) was added. The samples were analyzed before and after processing; tests included detection of free plasma hemoglobin (FPH), potassium ions (K+), glutamic oxalic transaminase (GOT), lactate dehydrogenase (LDH), proteins, and cytokines.


RESULTS
In the intraoperative model 2935 (SD 260) mL of blood was processed. The concentration of packed red cells was 63% and 80% of the red cells were recovered. In the postoperative model 652 (35) mL was processed, the packed red cell concentration was 67% and 81% of the red cells were recovered. Reductions were observed in the concentrations of white blood cells (72%), platelets (88%), GOT and LDH (75%), and proteins and K+ (>95%). Fifty percent of the red cells were recovered in the surgical compresses model. In the hemolysis model, the K+ and FPH concentrations were reduced more than 95%. In the cytokine model, up to 90% of the interleukin 1beta, interleukin 6, and tumor necrosis factor content was removed from the activated blood samples.


CONCLUSIONS
These findings suggest that the OrthoPAT system washes blood and salvages content effectively, recovering 80% of red cells. Moreover, its processing capacity (800-1000 mL x h(-1)) seems adequate for blood replacement in orthopedic surgery.
Muñoz Gómez
M
M
GIEMSA, Facultad de Medicina. Servicios de Anestesiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga. mmunoz@uma.es
Ariza Villanueva
D
D
Romero Ruiz
A
A
Muñoz Morán
E
E
Prat Arrojo
I
I
Gómez Luque
A
A
D001219:Aspartate Aminotransferases / Q000097:blood; D001798:Blood Proteins / Q000032:analysis; D001804:Blood Transfusion, Autologous / Q000295:instrumentation*; D002469:Cell Separation / Q000295:instrumentation*; D016207:Cytokines / Q000097:blood; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007958:Leukocyte Count; D008070:Lipopolysaccharides / Q000494:pharmacology; D008953:Models, Anatomic; D019637:Orthopedic Procedures; D011182:Postoperative Care / Q000295:instrumentation*; D011188:Potassium / Q000097:blood; D015503:Surgical Sponges
D001798:Blood Proteins; D016207:Cytokines; D006454:Hemoglobins; D008070:Lipopolysaccharides; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D011188:Potassium