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Published on: September 7, 2018
[Changes in ionized calcium and citrate levels in dogs during mechanical autotransfusion with heparin, ACD and CPD]
Insights
Autotransfusion of citrated blood in dogs caused a significant drop in ionized calcium (Ca++), especially with CPD anticoagulant. This calcium decrease, not total calcium changes, is linked to cardiac depression post-transfusion.
Area of Science:
- Cardiovascular Physiology
- Transfusion Medicine
- Biochemistry
Background:
- Autotransfusion (AT) involves reinfusing a patient's own blood.
- Citrate-based anticoagulants are commonly used in blood preservation.
- Cardiac function can be affected by alterations in serum calcium and citrate levels during AT.
Purpose of the Study:
- To investigate the effects of different blood anticoagulants on serum ionized calcium (Ca++), total calcium, and citrate levels during autotransfusion in dogs.
- To determine the relationship between these biochemical changes and cardiac depression post-AT.
Main Methods:
- Serum samples were analyzed for Ca++, total calcium, and citrate levels in dogs undergoing AT.
- Blood was stabilized with heparin, Acid Citrate Dextrose (ACD), or Citrate Phosphate Dextrose (CPD) anticoagulant.
- Aortic pressure (AOP) was continuously monitored to correlate with blood sample timing.
Main Results:
- Ionized calcium (Ca++) levels dropped significantly post-AT, with a 27% decrease with ACD and 34% with CPD.
- Serum citrate levels increased substantially, particularly with CPD (521% increase) compared to ACD (174% increase).
- Total serum calcium levels remained stable throughout the procedure.
Conclusions:
- The cardiac depression observed after autotransfusion of citrated blood is primarily attributed to the significant drop in ionized calcium (Ca++).
- CPD anticoagulant resulted in a more pronounced decrease in Ca++ and a greater increase in citrate compared to ACD.
- These findings highlight the critical role of anticoagulant choice in managing electrolyte balance and cardiac function during autotransfusion.
Abstract:
The control of ionized calcium (Ca++), total calcium, and citrate levels in serum were determined in dogs during autotransfusion (AT) of blood stabilized with heparin, ACD (formula B) and CPD. Blood samples were taken according to the changes of aortic pressure (AOP), which was continuously monitored. Taking the values during the stable phase of AOP preceding the AT as baseline, Ca++ dropped by 27% with ACD and by 34% with CPD at the maximum decrease of AOP immediately after the AT. The corresponding increase of citrate was 174% with ACD and 521% with CPD, while total calcium remained stable. Thus cardiac depression after AT of citrated blood seems to be mainly caused by the drop of Ca++, which is significantly more pronounced with CPD, corresponding to the higher content of citrate.
