Document Detail


Sedimentation method for preparation of postoperatively salvaged unwashed shed blood in orthopaedic surgery.
MedLine Citation:
PMID:  20639211     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Salvage and return of unwashed shed blood (USB) after total knee replacement (TKR) is an established blood-saving technique, but some authors question its efficacy and safety and suggest that the shed blood be washed before returning. We evaluated a colloid-based sedimentation method for improving and standardizing the quality of USB collected after TKR without the need for washing. METHODS: Experiments were performed to find the optimal colloid dose and sedimentation time using diluted donated venous blood. USB samples (n=52) were drawn from the reinfusion bag and mixed with hydroxyethyl starch or gelatine solutions (15-30%, colloid solution volume/total volume × 100). USB red blood cells (RBCs) were allowed to settle by gravity for 30 min, supernatant was evacuated from the syringe, and RBC concentrate was analysed. RBC recovery and other blood cell and chemical removal were calculated according to changes in USB volume and haematocrit. Twenty-five samples from leucodepleted packed RBCs were analysed as a comparator group. RESULTS: Mean haemoglobin (Hb) of USB was 10.9 g dl(-1). After colloid treatment, 90% of RBCs were recovered, and USB Hb was similar to that of leucodepleted packed RBCs (n=25) (18.9 vs 19.6 g dl(-1), respectively; P=NS). In addition, the procedure reduced USB content of leucocytes (60%), platelets (48%), total protein (76%), cytokines (70-77%), and plasma-free haemoglobin (53%), without major differences between colloids. CONCLUSIONS: Sedimentation of USB with colloid solutions provides a low-cost alternative for improving and standardizing the quality of salvaged USB after TKR.
Authors:
M Muñoz; S García-Segovia; D Ariza; A Cobos; J A García-Erce; D Thomas
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-16
Journal Detail:
Title:  British journal of anaesthesia     Volume:  105     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-14     Completed Date:  2010-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  457-65     Citation Subset:  IM    
Affiliation:
Transfusion Medicine, School of Medicine, University of Málaga, Campus de Teatinos, 29071 Málaga, Spain. mmunoz@uma.es
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MeSH Terms
Descriptor/Qualifier:
Arthroplasty, Replacement, Knee*
Blood Loss, Surgical
Blood Sedimentation
Blood Transfusion, Autologous / methods*
Colloids
Cytokines / blood
Hemodilution / methods
Humans
Leukocyte Reduction Procedures / methods
Lymphocyte Subsets
Postoperative Care / methods
Tissue and Organ Harvesting / methods*
Chemical
Reg. No./Substance:
0/Colloids; 0/Cytokines

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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