Booke M, Fobker M, Fingerhut D, Storm M, Mortlemans Y, Van Aken H
Department of Anesthesiology, University of Münster, Germany.
Anesth Analg. 1997 Nov;85(5):959-62. doi: 10.1097/00000539-199711000-00002.
Intraoperative autotransfusion of scavenged blood is an established method to reduce the need for perioperative homologous blood transfusion. However, if fat particles contaminate blood suctioned from the wound site, no reliable method is available to remove them during the washing and concentration of the recycled blood. A new generation of autotransfusion devices (e.g., continuous autotransfusion system [CATS]), based on separation chambers used in cell separators or plasmapheresis devices, allows continuous procession of the collected blood, in contrast with the discontinuous process used in conventional autotransfusion devices such as the Cell Saver 5. Theoretically, the continuous system should be more efficient than the discontinuous system in eliminating fat. Outdated, 36-day-old packed red blood cells, 600 mL, were mixed with 500 mL of lactated Ringer's solution and 200 mL of soya oil. Soya oil was used because it has a fatty acid composition similar to that of fat found in bone marrow. The blood mixture was then washed and concentrated by using either the CATS or the Cell Saver 5. Six samples were processed by each device. The CATS eliminated the soya oil (200 mL) completely, whereas the Cell Saver 5 delivered 30.3 +/- 7.8 mL soya oil into the retransfusion bag. The new generation of autotransfusion devices allows complete removal of fat particles.
Autotransfusion devices serve to wash and retransfuse blood scavenged from the wound site. However, they cannot completely remove fat particles. This in vitro investigation showed that a new device completely removes fat particles and thus prevents retransfusion of fat.
术中回收式自体输血是一种既定的减少围手术期异体输血需求的方法。然而，如果脂肪颗粒污染了从伤口部位抽吸的血液，在回收血液的清洗和浓缩过程中，没有可靠的方法来去除它们。基于细胞分离器或血浆置换装置中使用的分离室的新一代自体输血装置（例如，连续自体输血系统 [CATS]），与传统自体输血装置（如Cell Saver 5）使用的间断过程相反，允许对收集的血液进行连续处理。从理论上讲，连续系统在消除脂肪方面应该比间断系统更有效。将600 mL过时36天的浓缩红细胞与500 mL乳酸林格氏液和200 mL大豆油混合。使用大豆油是因为其脂肪酸组成与骨髓中发现的脂肪相似。然后使用CATS或Cell Saver 5对血液混合物进行清洗和浓缩。每个装置处理六个样本。CATS完全去除了大豆油（200 mL），而Cell Saver 5将30.3±7.8 mL大豆油输送到回输袋中。新一代自体输血装置能够完全去除脂肪颗粒。
自体输血装置用于清洗和回输从伤口部位回收的血液。然而，它们不能完全去除脂肪颗粒。这项体外研究表明，一种新装置能完全去除脂肪颗粒，从而防止脂肪回输。
