Baumann Cyrille, Lamesic Goran, Weiss Markus, Cushing Melissa M, Haas Thorsten
Department of Anaesthesia, University Children's Hospital Zurich, Zurich, Switzerland.
Paediatr Anaesth. 2015 Mar;25(3):258-64. doi: 10.1111/pan.12535. Epub 2014 Sep 30.
Autotransfusion in pediatric anesthesia is beneficial in several clinical settings; however, more frequent usage is deterred by process-related costs and the fact that the absolute volume of blood returned may be minimal.
Two autotransfusion devices (CATS, Fresenius Kabi AG, and Sorin Xtra, Sorin GmbH) with different technologies were evaluated to determine the minimum volume necessary to efficiently process salvage blood.
Banked blood was diluted to simulate different clinical scenarios. Volume and red cell mass in returned blood were analyzed as a function of initial volume and red cell mass in the collection reservoir using incremental increases in the volume of blood added to the reservoir.
The volume of the returned processed blood for infusion was dependent on degree of dilution and blood volume in the reservoir. The CATS required a smaller initial minimum volume to process and successfully return; however, the Xtra provided a more efficient recovery at low initial collected volumes. Using test blood of various degrees of dilution, the CATS and Xtra were able to return blood for retransfusion after a mean initial red cell mass of 48.7 ml (±4.9 ml) and 53.7 ml (±5.0 ml) were processed, respectively.
Red cell mass rather than salvaged blood volume represents a reliable predictor of the successful use of an autotransfusion device. Measuring the hematocrit of the salvaged blood could improve the use of the devices. The investigated devices are likely to be roughly equivalent in effectiveness.
小儿麻醉中的自体输血在多种临床情况下是有益的；然而，由于与操作过程相关的成本以及回输血液的绝对量可能很少，其使用频率受到了限制。
评估两种采用不同技术的自体输血装置（CATS，费森尤斯卡比股份公司；以及索林Xtra，索林有限公司），以确定有效处理回收血液所需的最小量。
将库存血进行稀释以模拟不同的临床情况。通过逐步增加添加到储血器中的血液量，分析回输血液中的体积和红细胞量与储血器中初始体积和红细胞量之间的函数关系。
回输用于输注的处理后血液的体积取决于稀释程度和储血器中的血量。CATS需要较小的初始最小量来进行处理并成功回输；然而，Xtra在初始采集量较低时能提供更高效的回收。使用不同稀释度的测试血液，CATS和Xtra分别在处理了平均初始红细胞量为48.7毫升（±4.9毫升）和53.7毫升（±5.0毫升）后能够回输血液用于再输血。
红细胞量而非回收血液量是自体输血装置成功使用的可靠预测指标。测量回收血液的血细胞比容可改善这些装置的使用。所研究的装置在有效性方面可能大致相当。
