Department of Anaesthesia, Royal Brompton Hospital, London, UK.
Anaesthesia. 2011 Oct;66(10):901-6. doi: 10.1111/j.1365-2044.2011.06862.x. Epub 2011 Aug 24.
At the same time as cell salvage was introduced into our institution for all patients undergoing cardiac surgery with cardiopulmonary bypass, we established a supporting programme of quality assurance to reassure clinicians regarding safety and efficacy. Data collected in patients operated on between 2001 and 2007 included pre- and post-wash heparin concentration, haemoglobin concentration and free haemoglobin concentration. Cell salvage was used in 6826 out of a total of 7243 patients (94%). Post-wash heparin concentration was consistently low (always < 0.4 IU.ml(-1)). There was a significant decrease in post-wash haemoglobin concentration in 2003 compared to 2001, from a median (IQR [range]) of 19.6 (16.7-22.2 [12.9-25.5]) g.dl(-1) to 17.5 (13.6-20.8 [12.6-23.7]) g.dl(-1) (p < 0.015). In addition, there was a significant increase in free plasma haemoglobin in 2006 compared to 2001, from 0.5 (0.3-0.8 [0.1-2.6]) g.l(-1) to 0.8 (0.3-1.4 [0.3-5.2]) g.l(-1) (p < 0.001). This programme led to the detection of a change in operator behaviour in 2003 and progressive machine deterioration resulting in appropriate fleet replacement in 2006. You can respond to this article at http://www.anaesthesiacorrespondence.com.
与此同时，我们医院在所有接受体外循环心脏手术的患者中引入了细胞回收技术，并建立了一个支持质量保证的方案，以确保临床医生对其安全性和有效性放心。在 2001 年至 2007 年接受手术的患者中收集的数据包括洗涤前和洗涤后的肝素浓度、血红蛋白浓度和游离血红蛋白浓度。在总共 7243 名患者中，有 6826 名（94%）使用了细胞回收技术。洗涤后的肝素浓度始终很低（<0.4IU.ml(-1)）。与 2001 年相比，2003 年洗涤后血红蛋白浓度显著下降，中位数（IQR[范围]）从 19.6（16.7-22.2[12.9-25.5]）g.dl(-1)降至 17.5（13.6-20.8[12.6-23.7]）g.dl(-1)（p<0.015）。此外，与 2001 年相比，2006 年游离血浆血红蛋白显著增加，从 0.5（0.3-0.8[0.1-2.6]）g.l(-1)增至 0.8（0.3-1.4[0.3-5.2]）g.l(-1)（p<0.001）。该方案导致 2003 年发现操作人员行为发生变化，并在 2006 年导致机器逐渐恶化，从而进行了适当的设备更换。您可以在 http://www.anaesthesiacorrespondence.com 上对此文章进行回复。
