Vorweg M, Muckel G, Knüttgen D, Schindler A, Doehn M
Abteilung für Anästhesie, Krankenhaus Merheim.
Anaesthesist. 1998 Dec;47(12):979-81. doi: 10.1007/s001010050655.
Disorders in blood coagulation during the use of autotransfusion have been reported in recent literature. We wondered whether or not heparine, remaining in the prepared sample of retransfusion blood might be responsible for these disturbances.
Therefore we created a setting in which heparine was added to animal blood in order to imitate clinical situations during the use of the CELL SAVER.
According to our results the blood shows no irregular heparine load as long as the machine is used following the operating instructions. But if the volume of rinsing liquid is decreased or the pumpflow is increased, the heparine load is increased enormously (Table 1).
If the CELL SAVER is used with reduced volume of rinsing liquid or higher velocity of the pump, the coagulation status of the patient has to be monitored meticously.
近期文献报道了自体输血过程中血液凝固紊乱的情况。我们想知道,再输血血液制备样本中残留的肝素是否可能是这些紊乱的原因。
因此,我们创设了一种将肝素添加到动物血液中的环境,以模拟使用血液回收机时的临床情况。
根据我们的结果,只要按照操作说明使用机器,血液就不会出现肝素负荷异常。但如果冲洗液体积减少或泵流量增加,肝素负荷会大幅增加(表1)。
如果使用血液回收机时冲洗液体积减少或泵速提高,必须密切监测患者的凝血状态。