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[Evaluation of the OrthoPAT autologous transfusion system by experimental models simulating intra- and postoperative
M Muñoz Gómez1, D Ariza Villanueva, A Romero Ruiz
1GIEMSA, Facultad de Medicina. Servicios de Anestesiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga. mmunoz@uma.es
Objective:
To evaluate the efficacy of the OrthoPAT (Haemonetics) system for blood salvage and for removing chemical or cellular debris, by experimental models simulating intra- and postoperative conditions.
Material And Methods:
Blood samples (20%-25% packed red cells) were prepared for the intraoperative model (n=8) and the postoperative model (n=22). Surgical compresses were soaked in some samples (n=5). Other samples were supplemented with hemolyzed blood (n=7). From others cytokines were removed and blood activated with bacterial liposaccharides (n=10) was added. The samples were analyzed before and after processing; tests included detection of free plasma hemoglobin (FPH), potassium ions (K+), glutamic oxalic transaminase (GOT), lactate dehydrogenase (LDH), proteins, and cytokines.
Results:
In the intraoperative model 2935 (SD 260) mL of blood was processed. The concentration of packed red cells was 63% and 80% of the red cells were recovered. In the postoperative model 652 (35) mL was processed, the packed red cell concentration was 67% and 81% of the red cells were recovered. Reductions were observed in the concentrations of white blood cells (72%), platelets (88%), GOT and LDH (75%), and proteins and K+ (>95%). Fifty percent of the red cells were recovered in the surgical compresses model. In the hemolysis model, the K+ and FPH concentrations were reduced more than 95%. In the cytokine model, up to 90% of the interleukin 1beta, interleukin 6, and tumor necrosis factor content was removed from the activated blood samples.
Conclusions:
These findings suggest that the OrthoPAT system washes blood and salvages content effectively, recovering 80% of red cells. Moreover, its processing capacity (800-1000 mL x h(-1)) seems adequate for blood replacement in orthopedic surgery.
