Department of Anesthesiology, Magee Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
Transfusion. 2012 Jan;52(1):34-8. doi: 10.1111/j.1537-2995.2011.03217.x. Epub 2011 Jun 17.
There are several options for the salvage of postoperative shed red blood cells (RBCs). This study compared the characteristics of the returned RBCs collected using two different devices: one that washes and one that does not wash the collected RBCs.
Forty patients undergoing first-time total knee arthroplasty consented to participate. Twenty patients were operated on by a surgeon who routinely uses a device that does not wash the shed RBCs (unwashed group), the other 20 patients were operated on by surgeons who routinely use a device that washes and concentrates the collected RBCs (washed group). A small quantity of postprocessing RBCs were collected immediately before reinfusion and the amount of plasma-free hemoglobin (PFHb), and the mechanical fragility index (MFI) of the returned RBCs were determined.
The patients in both groups were well matched for age, sex, and length of stay. The mean percent hemolysis of the returned RBCs was not different between the unwashed and washed groups (1.22±0.30 vs. 1.24±0.42, p=0.895), while the mean total amount of returned PFHb was not different (0.51±0.12 g vs. 0.55±0.35 g, p<0.615). The ratio of total PFHb:total returned Hb was significantly lower for the washed group (0.0087±0.0023 vs. 0.0035±0.0011, p<0.0001). The MFI was higher in the washed group (1.71±0.55 vs. 0.53±0.42, p<0.001).
The washing device returned more Hb to the patients relative to the amount of free Hb.
术后流失的红细胞（RBC）有几种回收方法可供选择。本研究比较了两种不同回收装置收集的 RBC 的特点，一种是洗涤型，另一种是不洗涤型。
40 例行初次全膝关节置换术的患者同意参与本研究。20 例由常规不洗涤回收 RBC 的外科医生进行手术（未洗涤组），另外 20 例由常规洗涤和浓缩收集 RBC 的外科医生进行手术（洗涤组）。在回输前立即收集少量的 RBC 进行后处理，并测定返回 RBC 的游离血红蛋白（PFHb）量和机械脆性指数（MFI）。
两组患者在年龄、性别和住院时间方面匹配良好。未洗涤组和洗涤组返回 RBC 的平均溶血百分比无差异（1.22±0.30 对 1.24±0.42，p=0.895），而返回的 PFHb 总量也无差异（0.51±0.12 g 对 0.55±0.35 g，p<0.615）。洗涤组的总 PFHb：总回输 Hb 比值明显较低（0.0087±0.0023 对 0.0035±0.0011，p<0.0001）。洗涤组的 MFI 较高（1.71±0.55 对 0.53±0.42，p<0.001）。
与游离血红蛋白量相比，洗涤装置回输了更多的 Hb 给患者。
