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Systemic blood activation during and after autotransfusion
J P Schönberger1, W van Oeveren, J J Bredée
1Department of Cardiopulmonary Surgery, Catharina Hospital, Eindhoven, The Netherlands.
The Annals of Thoracic Surgery
|May 1, 1994
Summary
Autotransfusion systems activate blood, causing inflammatory responses. The Dideco system caused a greater inflammatory reaction and more blood loss than the Sorin system.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Transfusion Medicine
Background:
- Autotransfusion is used to reinfuse a patient's own shed blood during surgery.
- The activation of shed blood during autotransfusion can lead to systemic inflammatory responses.
- Different autotransfusion systems may vary in their potential to activate blood components.
Purpose of the Study:
- To compare the extent of shed blood activation between two autotransfusion systems (Sorin and Dideco).
- To investigate the effect of circulating blood activation following autotransfusion.
- To assess the impact of autotransfusion system type on systemic inflammatory reactions.
Main Methods:
- Prospective study in 28 patients (18 autotransfusion, 10 control) undergoing internal mammary artery bypass.
- Evaluation of two autotransfusion systems: Sorin (small filter contact area) and Dideco (large filter contact area).
- Measurement of inflammatory markers (thromboxane, fibrinogen degradation products, C3a, elastase) in shed and circulating blood.
Main Results:
- High concentrations of inflammatory markers were found in shed blood and circulating blood of autotransfused patients, but not in controls.
- The Dideco system induced a greater inflammatory response compared to the Sorin system.
- Dideco patients experienced greater shed blood loss and required more fluid resuscitation post-autotransfusion.
Conclusions:
- Both autotransfusion systems activate shed blood, leading to systemic inflammatory responses.
- The Dideco system, with its larger filter surface area, provokes a more significant inflammatory reaction than the Sorin system.
- Clinical relevance of hemodilution and need for blood products increases with higher volumes of infused shed blood, particularly with the Dideco system.