The effects of residual pump blood on patient plasma free haemoglobin levels post cardiac surgery.
At the end of cardiopulmonary bypass, there are invariably several hundred millilitres of residual pump blood in the reservoir, which can either be re-transfused or discarded. The objective of this prospective observational study was to investigate the quality of the residual pump blood, focusing on plasma free haemoglobin (pfHb) and blood cell counts. Fifty-one consecutive patients were included in the study. Forty-nine units of residual pump blood and 58 units of transfused red blood cell (RBC) concentrates were analysed. The mean preoperative pfHb of the patients was 0.057 ± 0.062 g/l, which increased gradually to 0.55 ± 0.36 g/l on arrival in the intensive care unit postoperatively. On the first postoperative day, the mean pfHb had returned to within the normal range. Our data showed that haemoglobin, haematocrit, and erythrocyte counts of residual pump blood were approximately 40% of the values in standardised RBC concentrates. Plasma free haemoglobin was significantly higher in residual pump blood compared to RBC concentrates, and nearly twice as high as the pfHb in patient blood samples taken contemporaneously. Our findings indicate that residual pump blood pfHb levels are markedly higher compared to patients' blood and RBC concentrates, but that its administration does not significantly increase patients' pfHb levels.
Anaesthetist, Department of Anaesthesiology, Georg-August-University Goettingen, Goettingen, Germany.
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Schotola
Anaesthetist, Department of Anaesthesiology, Georg-August-University Goettingen, Goettingen, Germany.
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AJ
Wetz
Cardiac Surgeon, Department of Cardiothoracic Transplantation and Mechanical Support, Brompton and Harefield Hospital, London, United Kingdom.
A F
AF
Popov
Anaesthetist, Department of Anaesthesiology, Georg-August-University Goettingen, Goettingen, Germany.
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Bergmann
Cardiac Surgeon, Department of Thoracic and Cardiovascular Surgery, Georg-August-University Goettingen, Goettingen, Germany.
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Danner
Professor, Cardiac Surgeon, Department of Thoracic and Cardiovascular Surgery, Georg-August-University Goettingen, Goettingen, Germany.
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FA
Schöndube
Anaesthetist, Professor, Department of Anaesthesiology, Georg-August-University Goettingen, Goettingen, Germany.
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M
Bauer
Anaesthetist, Professor, Department of Anaesthesiology, Georg-August-University Goettingen, Goettingen, Germany.
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A
Bräuer
D000368:Aged; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D004906:Erythrocyte Count; D017707:Erythrocyte Transfusion; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D006454:Hemoglobins
plasma free haemoglobin, residual pump blood, cardiac surgery, blood transfusion, patient blood management