Do repeated runs of a cell saver device increase the pro-inflammatory properties of washed blood?
OBJECTIVE
Intra-operative cell salvage is increasingly used, especially in longer cases with continuing blood loss. However it is unknown if the quality of processed blood is affected when larger quantities of blood are processed. We hypothesized that the quality of the washed blood decreases after multiple runs.


METHODS
Intra-operative cell salvage was performed in 42 consecutive patients undergoing cardiac surgery. When 1250 ml of blood was collected in the blood collection reservoir, this was processed and returned to the patient. In 21 patients more than 2500 ml of blood was collected during the whole procedure, thus allowing at least two subsequent runs with the auto-transfusion device. Blood samples were drawn from the blood collection reservoir of the cell saver device before, and from the processed blood after each run.


RESULTS
After the first run interleukin-6 concentrations were reduced with 85% (from 21+/-35 microg/l to 3.1+/-4.4 microg/l), whereas after the second run 72% was removed (63+/-69 microg/l to 17.6+/-25.3 microg/l). Leukocyte counts almost doubled after both processing runs (from 2.6+/-1.5 x 10(9)/l to 5+/-3.6 x 10(9)/l) and from 3.9+/-2.2 x 10(9)/l to 7.7+/-5.9 x 10(9)/l), hemoglobin concentration (14.8+/-1.6 mmol/l vs 15.0+/-1.1 mmol/l), free hemoglobin (2.3+/-1.6g/l vs 2.1+/-1.4 g/l) and platelet counts (18+/-9 x 10(9)/l vs 28+/-23 x 10(9)/l) were not different between the two runs.


CONCLUSIONS
Our results suggest, based on interleukin-6 and free hemoglobin washout that the quality of the processed blood remains constant with multiple runs of the cell saver device.
Department of Anesthesiology, University Medical Centre Groningen, University of Groningen, The Netherlands. verm0030@planet.nl
Wytze J
WJ
Vermeijden
Ans
A
Hagenaars
Willem
W
van Oeveren
Adrianus J
AJ
de Vries
D000368:Aged; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous; D006348:Cardiac Surgical Procedures; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000209:etiology; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D007430:Intraoperative Care / Q000379:methods*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D007507:Therapeutic Irrigation; D020858:Tissue and Organ Harvesting / Q000379:methods*
D006454:Hemoglobins; D018836:Inflammation Mediators; D015850:Interleukin-6