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Left ventricular pump failure associated with diffuse coagulation in experimental intraoperative autotransfusion.
The Journal of Trauma
|April 1, 1978
Summary
Autotransfusion using acid citrate dextrose or high-dose heparin did not impact cardiac function in pigs. However, low-dose heparin impaired left ventricular performance due to coagulation issues.
Area of Science:
- Cardiovascular Physiology
- Transfusion Medicine
- Surgical Anticoagulation
Background:
- Autotransfusion is a method to reinfuse a patient's own blood, often collected during surgery.
- Ensuring adequate anticoagulation is critical for the viability and safety of autotransfused blood.
- The effects of different anticoagulation strategies on cardiac performance during autotransfusion require further elucidation.
Purpose of the Study:
- To evaluate the impact of two anticoagulation methods on cardiac performance during autotransfusion in pigs.
- To compare the efficacy of acid citrate dextrose (ACD) solution versus systemic heparinization in preventing coagulation-related complications.
- To determine the threshold for heparin dosage that may adversely affect cardiac function.
Main Methods:
- Pigs underwent autotransfusion procedures with blood collected from the peritoneal cavity.
- Two anticoagulation regimens were tested: ACD solution (1:10 v/v) for reservoir anticoagulation and systemic heparinization (300 IU/kg or 100 IU/kg).
- Cardiac performance was monitored to assess the effects of each anticoagulation strategy.
Main Results:
- Autotransfusion with ACD solution or high-dose systemic heparin (300 IU/kg) did not significantly alter cardiac performance.
- A rapid decline in left ventricular pump performance was observed when a low dose of systemic heparin (100 IU/kg) was administered.
- Findings suggest that diffuse coagulation is the likely cause of cardiac deterioration with low-dose heparin.
Conclusions:
- ACD solution and high-dose systemic heparin are safe anticoagulation methods for porcine autotransfusion concerning cardiac performance.
- Low-dose systemic heparin (100 IU/kg) poses a risk of impaired cardiac function due to induced coagulation.
- Careful selection of anticoagulation protocols is essential to prevent adverse hemodynamic effects during autotransfusion.