Department of Anesthesiology, Vestfold Hospital Trust, Tønsberg, Norway.
Transfusion. 2012 Aug;52(8):1761-9. doi: 10.1111/j.1537-2995.2011.03528.x. Epub 2012 Feb 5.
Levels of proinflammatory mediators in unwashed salvaged blood from abdominal aortic aneurism (AAA) surgery are unknown. We hypothesized that there are higher levels of these mediators in unwashed blood salvaged in AAA surgery compared to hip replacement surgery.
Ten patients scheduled for AAA surgery (Group A) and 10 patients for total hip replacement surgery (Group H) were included. Blood samples from the autotransfusion set were obtained during surgery and arterial samples before, during, and 6 hours after surgery. Determination of interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-α, activated complement 3 (C3a), and high-sensitivity C-reactive protein (CRP) were performed. Salvaged blood was not retransfused.
Levels (median [range]) of IL-8 in blood in the salvage system were higher in Group A versus Group H (215.3 [22.5-697.2] vs. 35.3 [16.7-66.6] pg/mL; p = 0.002). Higher levels of IL-6 were also seen in Group A versus Group H (60.0 [52.6-62.2] vs. 42.34 [19.4-62.2] pg/mL; p = 0.049). Levels of IL-6 in blood sampled during surgery were approximately fivefold higher in Group A versus Group H (p = 0.023), whereas approximately 70% higher levels of C3a were observed in Group H versus Group A (p = 0.021). Postoperative concentrations of IL-1β (p = 0.002), IL-6 (p = 0.001), and IL-8 (0.005) were higher in Group A versus Group H.
Salvaged blood in AAA surgery contains substantially higher levels of proinflammatory mediators compared to blood in total hip replacement surgery.
腹主动脉瘤（AAA）手术中未清洗回收血液中的促炎介质水平尚不清楚。我们假设与髋关节置换手术相比，AAA 手术中未清洗回收的血液中这些介质水平更高。
纳入 10 例拟行 AAA 手术的患者（A 组）和 10 例行全髋关节置换术的患者（H 组）。术中从自体输血装置采集血样，在手术前、手术中和手术后 6 小时采集动脉血样。检测白细胞介素（IL）-1β、IL-6、IL-8、肿瘤坏死因子-α、活化补体 3（C3a）和高敏 C 反应蛋白（CRP）。未将回收的血液重新输注。
A 组回收系统中血液的 IL-8 水平（中位数[范围]）明显高于 H 组（215.3[22.5-697.2] vs. 35.3[16.7-66.6]pg/ml；p=0.002）。A 组的 IL-6 水平也较高（60.0[52.6-62.2] vs. 42.34[19.4-62.2]pg/ml；p=0.049）。A 组手术期间采集的血液中 IL-6 水平明显高于 H 组（p=0.023），而 H 组的 C3a 水平约高出 70%（p=0.021）。与 H 组相比，A 组术后 IL-1β（p=0.002）、IL-6（p=0.001）和 IL-8（0.005）的浓度更高。
与全髋关节置换术相比，AAA 手术中回收的血液中含有大量更高水平的促炎介质。
