title: Residual blood processing by centrifugation, cell salvage or ultrafiltration in cardiac surgery:  effects on clinical hemostatic and ex-vivo rheological parameters.
abstract: The study compared the effects of three blood concentration techniques after cardiopulmonary bypass on clinical hemostatic and ex-vivo rheological parameters. Residual blood of patients undergoing elective cardiac surgery was processed by centrifugation, cell salvage or ultrafiltration, and retransfused (n = 17 per group). Study parameters included blood loss, (free) hemoglobin, hematocrit, fibrinogen and erythrocyte aggregation, deformability and 2,3-diphosphoglycerate content. Patient characteristics were similar between groups. Ultrafiltration was associated with the highest weight of the transfusion bag [649 ± 261 vs. 320 ± 134 g (centrifugation) and 391 ± 158 g (cell salvage); P < 0.01]. Cell salvage resulted in the lowest hemolysis levels in the transfusion bag. Retransfusion of cell saver blood induced the largest gain in postoperative patient hemoglobin levels when compared to centrifugation and ultrafiltration, and was associated with the largest increase in 2,3-diphosphoglycerate when compared to ultrafiltration (Δ2,3-diphosphoglycerate 1.34 ± 1.92 vs. -0.77 ± 1.56 mmol/l; P = 0.03). Cell salvage is superior with respect to postoperative hemoglobin gain and washout of free hemoglobin when compared to centrifugation or ultrafiltration.
authors: Department of Cardio-Thoracic Surgery, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, the Netherlands.
authors: Alexander B
authors: AB
authors: Vonk
authors: Warayouth
authors: W
authors: Muntajit
authors: Pranav
authors: P
authors: Bhagirath
authors: Laurentius J
authors: LJ
authors: van Barneveld
authors: Johannes W
authors: JW
authors: Romijn
authors: Roel
authors: R
authors: de Vroege
authors: Christa
authors: C
authors: Boer
mesh_terms: D000368:Aged; D001804:Blood Transfusion, Autologous / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002498:Centrifugation / Q000379:methods*; D005260:Female; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012212:Rheology / Q000379:methods*