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Related Experiment Videos

Blood substitution and complement activation.

U Schött1, O Berséus, P Järemo

  • 1Department of Anesthesiology and Intensive Care, Orebro Medical Center Hospital, Sweden.

Acta Anaesthesiologica Scandinavica
|October 1, 1987
PubMed
Summary

Infusing stored plasma during hip replacement surgery significantly increased complement activation, indicated by elevated C3a-desArg levels. Blood component therapy using SAGM-ERC and dextran did not affect complement activation, suggesting safer blood replacement strategies.

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Area of Science:

  • Anesthesiology
  • Immunology
  • Transfusion Medicine

Background:

  • Total hip arthroplasty (THA) involves significant blood loss, necessitating transfusion strategies.
  • Epidural anesthesia is commonly used for THA, with varying durations and adjuncts.
  • Complement activation is a concern during surgical procedures and blood product administration.

Purpose of the Study:

  • To investigate the impact of different blood replacement strategies and prolonged epidural anesthesia on complement activation during THA.
  • To compare the effects of stored plasma versus erythrocyte concentrate with dextran on complement activation markers.

Main Methods:

  • A randomized study of 45 THA patients under epidural anesthesia.
  • Three groups received different blood replacement and postoperative analgesia regimens.

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  • Plasma C3a-des-arginine (C3a-desArg) levels were measured preoperatively and at several time points postoperatively using radioimmunoassay.

    • Main Results:

    • Plasma infusion in Group III significantly increased C3a-desArg levels compared to preoperative values and other groups (P < 0.01).
    • No significant differences in plasma C3 and C4 levels were observed between groups.
    • Blood component therapy with SAGM-ERC and dextran-60 did not significantly elevate C3a-desArg levels.

    Conclusions:

    • Infusion of non-frozen stored plasma can enhance or initiate endogenous complement activation.
    • Blood component therapy using SAGM-ERC and dextran-60 appears to be a safer alternative regarding complement activation.
    • These findings have implications for optimizing transfusion protocols in major orthopedic surgery.