Waters Jonathan H, Lee Julia ShinJung, Karafa Matthew T
Department of General Anesthesiology, Cleveland Clinic Foundation, 9500 Euclid Avenue E31, Cleveland, OH 44195, USA.
Anesth Analg. 2002 Nov;95(5):1312-7, table of contents. doi: 10.1097/00000539-200211000-00040.
Cell salvage (CS) is one of the modalities that can be used during surgery to decrease the use of allogeneic blood. Unlike acute normovolemic hemodilution, the efficiency of CS has not been mathematically modeled. In this article, we hypothesized that a mathematical model could predict the decline of hematocrit during CS. The model that was developed accounts for both the effect of decreasing the hematocrit because of blood loss and the effect of increasing hematocrit because of the readministration of washed blood in an isovolemic patient. The efficiency of CS is defined to be the maximum allowable blood loss (MABL) for a fixed blood volume and a fixed transfusion trigger. For demonstration purposes, variables used for a hypothetical patient included an estimated blood volume of 5000 mL, a presurgery hematocrit of 45%, and a transfusion trigger of 21%. The MABL in a typical case was 9600 mL, with a CS red cell recovery rate of 60%. Patient records from a convenience sample showed an average recovery rate of 57% with 20% variability. This mathematical model suggests that CS can be a highly effective blood conservation method when red blood cell collection is optimal.
In this study, a mathematical model of cell salvage was developed. The model was then matched against real clinical cases to gain an understanding of the variables that modify cell salvage efficiency. The model illustrates that cell salvage can be a highly effective method of avoiding blood transfusion.
细胞回收（CS）是手术中可用于减少异体血使用的方法之一。与急性等容血液稀释不同，CS的效率尚未进行数学建模。在本文中，我们假设可以建立一个数学模型来预测CS期间血细胞比容的下降。所建立的模型既考虑了因失血导致血细胞比容降低的影响，也考虑了在等容患者中回输洗涤红细胞导致血细胞比容升高的影响。CS的效率定义为固定血容量和固定输血触发值时的最大允许失血量（MABL）。为便于演示，用于假设患者的变量包括估计血容量5000 mL、术前血细胞比容45%和输血触发值21%。典型病例中的MABL为9600 mL，CS红细胞回收率为60%。来自便利样本的患者记录显示平均回收率为57%，变异性为20%。该数学模型表明，当红细胞采集最佳时，CS可以是一种非常有效的血液保护方法。
在本研究中，建立了细胞回收的数学模型。然后将该模型与实际临床病例进行匹配，以了解影响细胞回收效率的变量。该模型表明，细胞回收可以是一种避免输血的非常有效的方法。
