Document Detail


Intraoperative blood salvage and retransfusion from citrate treated wounds is safe and feasible.
MedLine Citation:
PMID:  20141340     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Allogenic blood transfusions are associated with increased morbidity and mortality in surgical patients. The study objective was to investigate the feasibility and safety of intraoperative autotransfusion of unwashed shed whole blood using a novel method. DESIGN: Twenty pigs were randomised to autotransfusion or crystalloid volume replacement. In two separate surgical wounds, the surfaces and 400 ml of shed blood were treated in situ with citrate, delivered with an equipment transforming suction to positive pressure. Central haemodynamics were monitored with a pulmonary artery catheter. Effects on oxygen-carrying capacity, formed blood elements, haemolysis, inflammation, metabolism, and coagulation were evaluated with biochemical analyses. RESULTS: No clinically relevant adverse effects on haemodynamics were encountered, apart from a decrease in cardiac output and mixed venous saturation similar to that in control animals. Haemoglobin level was better preserved in the autotransfused group (97 vs. 86 g/L, p=0.0007). There were no major differences in biochemical variables and no macroscopic clot formation precluding autotransfusion. CONCLUSIONS: The technique was safe and feasible for intraoperative blood salvage and autotransfusion. Haemodynamics and biochemical variables were similar to controls. The technique warrants further studies in humans, as it may contribute towards a reduction of allogenic blood transfusions.
Authors:
Christian Olsson; Per Olsson; Kjell Rådegran; Anders Owall
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  44     ISSN:  1651-2006     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-25     Completed Date:  2010-08-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  England    
Other Details:
Languages:  eng     Pagination:  177-82     Citation Subset:  IM    
Affiliation:
Cardiothoracic Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. christian.olsson@karolinska.se
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MeSH Terms
Descriptor/Qualifier:
Animals
Anticoagulants / pharmacology*
Biological Markers / blood
Blood Loss, Surgical / prevention & control*
Blood Transfusion, Autologous* / adverse effects
Cardiac Surgical Procedures*
Citrates / pharmacology*
Feasibility Studies
Heart Atria / surgery
Hemodynamics
Intraoperative Care
Isotonic Solutions / administration & dosage
Models, Animal
Plasma Substitutes / administration & dosage
Swine
Time Factors
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Biological Markers; 0/Citrates; 0/Isotonic Solutions; 0/Plasma Substitutes; 0/crystalloid solutions; 18996-35-5/sodium citrate

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