title: Influence of mechanical cell salvage on red blood cell aggregation, deformability, and 2,3-diphosphoglycerate in patients undergoing cardiac surgery with cardiopulmonary bypass.
abstract: BACKGROUND
  Mechanical cell salvage is increasingly used during cardiac surgery. Although this procedure is considered safe, it is unknown whether it affects the red blood cell (RBC) function, especially the RBC aggregation, deformability, and the contents of 2,3-diphosphoglycerate (2,3-DPG). This study examines the following: (1) whether the cell salvage procedure influences RBC function; and (2) whether retransfusion of the salvaged blood affects RBC function in patients.
  
  
  METHODS
  Forty patients undergoing cardiac surgery with cardiopulmonary bypass were randomly allocated to a cell saver group (n = 20) or a control group (n = 20). In the cell saver group, the blood aspirated from the wound area and the residual blood from the heart-lung machine were processed with a continuous-flow cell saver before retransfusion. In the control group this blood was retransfused without processing. The RBC aggregation and deformability were measured with a laser-assisted optical rotational cell analyzer and 2,3,-DPG by conventional laboratory test.
  
  
  RESULTS
  The cell saver procedure did not influence the RBC aggregation but significantly reduced the RBC deformability (p = 0.007) and the content of RBC 2,3-DPG (p = 0.032). However, in patients receiving the processed blood, their intraoperative and postoperative RBC aggregation, deformability, and 2,3-DPG content did not differ from those of the control patients. Both groups of patients had a postoperative drop of RBC function as a result of hemodilution.
  
  
  CONCLUSIONS
  The mechanical cell salvage procedure reduces the RBC deformability and the cell 2,3-DPG content. Retransfusion of the processed blood by cell saver does not further compromise the RBC function in patients undergoing cardiac surgery with cardiopulmonary bypass.
authors.affiliation: Department of Biomedical Engineering, University Medical Centre Groningen, University of Groningen, the Netherlands. y.j.gu@med.umcg.nl
authors.forename: Y John
authors.initials: YJ
authors.lastname: Gu
authors.forename: Wytze J
authors.initials: WJ
authors.lastname: Vermeijden
authors.forename: Adrianus J
authors.initials: AJ
authors.lastname: de Vries
authors.forename: J Ans M
authors.initials: JA
authors.lastname: Hagenaars
authors.forename: Reindert
authors.initials: R
authors.lastname: Graaff
authors.forename: Willem
authors.initials: W
authors.lastname: van Oeveren
mesh_terms: D019794:2,3-Diphosphoglycerate / Q000097:blood*; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D004903:Erythrocyte Aggregation; D004907:Erythrocyte Deformability; D017707:Erythrocyte Transfusion / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D010983:Plateletpheresis / Q000379:methods*; D011300:Preoperative Care
chemical_list: D019794:2,3-Diphosphoglycerate