Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, China.
Int J Lab Hematol. 2013 Aug;35(4):385-92. doi: 10.1111/ijlh.12028. Epub 2012 Nov 26.
The aim of this study was to investigate the contribution of the perioperative cell salvage process to the changes in erythrocyte 2,3-disphosphoglycerate (2,3-DPG) and glucose-6-phosphate dehydrogenase (G-6-PD) levels and phosphatidylserine (PS) expression using a self-control study comparing washed blood with venous blood.
Thirty patients undergoing elective heart and blood vessel surgery were enrolled. Blood was collected and processed using a Fresenius continuous autotransfusion system device. 2,3-DPG and G-6-PD activities, as well as PS expression, from both venous and washed red blood cells (RBC) were measured. We also compared these indicators among washed RBC at 6 h, washed RBC at 0 h, and venous RBC.
2,3-DPG and G-6-PD activities in washed blood at 0 h were significantly higher than in venous RBC (2,3-DPG, venous vs. washed blood P < 0.05; G-6-PD, venous vs. washed blood P < 0.05). Flow cytometry results showed no differences between venous blood and washed RBC at 0 h (n = 23, P > 0.05). 2,3-DPG activity in washed RBC that were allowed to stand for 6 h decreased compared with that in venous blood (venous vs. washed blood at 6 h P < 0.01), whereas no significant difference was observed in G-6-PD activity (venous. vs. washed blood at 6 h P > 0.05).
Compared with venous RBC, washed RBC from intraoperative cell salvage exhibited good oxygen-carrying and antioxidant capacities. However, the oxygen-carrying capacity of washed RBC that were allowed to stand for 6 h was not as good as that of venous RBC. Thus, we suggest that washed RBC that were left to stand for more than 6 h should not be reinfused.
本研究旨在通过自身对照研究，比较洗涤前后血样，探讨围术期细胞回收过程对红细胞 2,3-二磷酸甘油酸（2,3-DPG）和葡萄糖-6-磷酸脱氢酶（G-6-PD）水平及磷脂酰丝氨酸（PS）表达变化的影响。
选择 30 例行择期心脏和大血管手术的患者。使用 Fresenius 连续自体输血系统设备采集和处理血液。测量静脉血和洗涤红细胞（RBC）中 2,3-DPG 和 G-6-PD 活性及 PS 表达，并比较洗涤 RBC 6 h 与 0 h、洗涤 RBC 0 h 与静脉血的上述指标。
洗涤 RBC 0 h 时的 2,3-DPG 和 G-6-PD 活性明显高于静脉血（2,3-DPG，静脉血与洗涤血 P<0.05；G-6-PD，静脉血与洗涤血 P<0.05）。流式细胞术结果显示，0 h 时静脉血与洗涤 RBC 之间无差异（n=23，P>0.05）。与静脉血相比，静置 6 h 的洗涤 RBC 2,3-DPG 活性降低（静脉血与洗涤血 6 h 时的比较 P<0.01），而 G-6-PD 活性无显著差异（静脉血与洗涤血 6 h 时的比较 P>0.05）。
与静脉 RBC 相比，术中细胞回收的洗涤 RBC 具有良好的携氧和抗氧化能力。然而，静置 6 h 的洗涤 RBC 携氧能力不如静脉 RBC。因此，我们建议静置超过 6 h 的洗涤 RBC 不应再回输。
