title: Quick biochemical markers for assessment of quality control of intraoperative cell salvage: a prospective observational study.
abstract: BACKGROUND
  Intraoperative Cell Salvage (ICS), hereby referred to 'mechanical red cell salvage', has been widely used in adult elective major surgeries to reduce requirement for homologous red blood cell transfusion and its associated complications. However, amount of free haemoglobin (fHb) from ICS has been shown related to incidence of renal failure. fHb is the most important indicator of quality control of cell salvaged blood, thus monitoring the fHb concentration is imperative to minimise renal injury. However, currently there has been lacking quick biochemical markers to monitor the levels of fHb during ICS. The aim of this study was to screen quick biochemical markers for evaluating the amount of fHb during use of intraoperative cell salvage.
  
  
  METHODS
  Twenty patients undergoing elective cardiovascular surgery were enrolled. Blood was collected and processed using a Fresenius continuous auto-transfusion system device. The concentration of fHb, albumin (Alb), and calcium (Ca) in three washing modes were measured, and their clearance rates were calculated. The correlations among the clearances and concentrations of fHb, albumin, and calcium were analysed.
  
  
  RESULTS
  In three washing modes, concentrations of albumin and calcium are significantly associated with amount of fHb:fHb(g/L) = 0.111 Alb(g/L) -0.108, R = 0.638, p = 0.000; fHb(g/L) = 1.721 Ca(mmol/L) +0.091, R = 0.514, p = 0.000. Furthermore, the clearance rates of albumin and calcium significantly predict clearance of fHb, CR(fHb) = 0.310 CR(ALB) + 0.686, R = 0.753, p = 0.000, CR(fHb) = 0.073 CR(Ca) + 0.913, R = 0.497, p = 0.000.
  
  
  CONCLUSIONS
  In clinic practice, clearance rates of albumin, or calcium can be used to evaluate the quality of salvaged blood, fHb. Bed-side measurement of calcium could offer a more feasible means for clinicians to undertake a real-time assessment of fHb.
authors.forename: Peng
authors.initials: P
authors.lastname: Dong
authors.forename: Ji
authors.initials: J
authors.lastname: Che
authors.forename: Xiuliang
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Anaesthesiology, Beijing Friendship Hospital, Capital Medical University, No, 95, Yong'an Road, Xicheng District, 100050 Beijing, China. 13601167650@139.com.
authors.forename: Ming
authors.initials: M
authors.lastname: Tian
authors.forename: Fang Gao
authors.initials: FG
authors.lastname: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000378:metabolism; D015415:Biomarkers / Q000097:blood*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous / Q000379:methods*; D002118:Calcium / Q000097:blood; D006348:Cardiac Surgical Procedures; D017558:Elective Surgical Procedures; D017707:Erythrocyte Transfusion / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D057725:Operative Blood Salvage / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D000418:Albumins; D015415:Biomarkers; D006454:Hemoglobins; D002118:Calcium