Tremain K D, Stammers A H, Niimi K S, Glogowski K R, Muhle M L, Trowbridge C C, Yang T
Division of Clinical Perfusion Education, School of Allied Health Professions, University of Nebraska Medical Center, Omaha, USA.
J Extra Corpor Technol. 2001 May;33(2):80-5.
Intraoperative autotransfusion is used in a variety of surgical procedures with the quantity of blood loss dependent upon numerous factors. These procedures may or may not produce a full autotransfusion bowl. The inadequate removal of contaminants has been correlated to the incomplete filling of bowls, resulting in a condition called "Salvaged Blood Syndrome." The purpose of this study was to assess the quality of aspirated whole blood after processing with an autotransfusion system using various fill volumes and two wash volumes. An in vitro circuit was designed to mimic the mechanical effects of extracorporeal flow on blood. Twenty-four Baylor-style bowls were filled at 400 mL min(-1) and washed at 300 mL min(-1). Two wash volumes, 1000 and 2000 mL, and three bowl volumes: low, mid, and full, were used in this study. The bowl volumes were determined by using red cell quantities of 60, 100, and 135 mL for the low-fill, mid-fill, and full bowls, respectively. Samples were drawn pre-autotransfusion and post-autotransfusion and analyzed for plasma-free hemoglobin, IL-8, white blood cell count, platelet count, albumin, and total protein. All data were analyzed using one-way analysis of variance (ANOVA) with significance accepted at p > or = .05. Plasma-free hemoglobin levels and hematocrit were concentrated significantly (p < .05) as bowl volume increased. A significant difference in IL-8 levels was found in the wash volumes in the low-fill bowls (p < .02). Platelet count was significantly decreased between the full bowl with 1000 mL wash and the full bowl with 2000 mL wash (p < .0004). Total protein reduction was significantly less in the low-fill bowl with 1000 mL wash as compared to the other bowl treatments (p < .05). In conclusion, the quality of the washed product did not vary significantly between fill or wash volumes, with the exception of the low-fill bowl with 1000 mL wash.
术中自体输血用于多种外科手术，失血量取决于众多因素。这些手术可能会也可能不会产生满的自体输血碗。污染物清除不充分与碗未完全装满有关，导致一种称为“回收血液综合征”的情况。本研究的目的是评估使用不同填充量和两种洗涤量的自体输血系统处理后抽吸全血的质量。设计了一个体外循环来模拟体外血流对血液的机械作用。以400 mL min(-1)的速度填充24个贝勒式碗，并以300 mL min(-1)的速度洗涤。本研究使用了两种洗涤量，即1000 mL和2000 mL，以及三种碗容量：低、中、满。低填充碗、中填充碗和满碗的碗容量分别通过使用60 mL、100 mL和135 mL的红细胞量来确定。在自体输血前和自体输血后采集样本，并分析无血浆血红蛋白、白细胞介素-8、白细胞计数、血小板计数、白蛋白和总蛋白。所有数据均使用单因素方差分析（ANOVA）进行分析，显著性水平设定为p≥0.05。随着碗容量增加，无血浆血红蛋白水平和血细胞比容显著升高（p<0.05）。在低填充碗中，不同洗涤量的白细胞介素-8水平存在显著差异（p<0.02）。1000 mL洗涤的满碗和2000 mL洗涤的满碗之间血小板计数显著降低（p<0.0004）。与其他碗处理相比，1000 mL洗涤的低填充碗中总蛋白减少显著较少（p<0.05）。总之，除了1000 mL洗涤的低填充碗外，洗涤产品的质量在填充量或洗涤量之间没有显著差异。
