Quick biochemical markers for assessment of quality control of intraoperative cell salvage: a prospective observational study

Journal of Cardiothoracic Surgery

Fang Gao Smith¹  Ming Tian²  Xiuliang Li²  Ji Che²  Peng Dong² 

[1] Perioperative, Critical Care and Trauma Trials Group, University of Birmingham, Edgbaston B15 2WB, Birmingham, UK;Department of Anaesthesiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Xicheng District, 100050 Beijing, China

关键词: Calcium;    Albumin;    Free haemoglobin;    Clearance rate;    Cell salvage;   

Others  :  823422
DOI  :  10.1186/1749-8090-9-86

 received in 2014-03-19, accepted in 2014-05-06,  发布年份 2014

【 摘 要 】

Background

Intraoperative Cell Salvage (ICS), hereby referred to ‘mechanical red cell salvage’, has been widely used in adult elective major surgeries to reduce requirement for homologous red blood cell transfusion and its associated complications. However, amount of free haemoglobin (fHb) from ICS has been shown related to incidence of renal failure. fHb is the most important indicator of quality control of cell salvaged blood, thus monitoring the fHb concentration is imperative to minimise renal injury. However, currently there has been lacking quick biochemical markers to monitor the levels of fHb during ICS. The aim of this study was to screen quick biochemical markers for evaluating the amount of fHb during use of intraoperative cell salvage.

Methods

Twenty patients undergoing elective cardiovascular surgery were enrolled. Blood was collected and processed using a Fresenius continuous auto-transfusion system device. The concentration of fHb, albumin (Alb), and calcium (Ca) in three washing modes were measured, and their clearance rates were calculated. The correlations among the clearances and concentrations of fHb, albumin, and calcium were analysed.

Results

In three washing modes, concentrations of albumin and calcium are significantly associated with amount of fHb:fHb(g/L) = 0.111Alb(g/L) –0.108, R = 0.638, p = 0.000; fHb(g/L) = 1.721Ca(mmol/L) +0.091, R = 0.514, p = 0.000. Furthermore, the clearance rates of albumin and calcium significantly predict clearance of fHb, CR_fHb = 0.310CR_ALB + 0.686, R = 0.753, p = 0.000, CR_fHb = 0.073 CR _Ca + 0.913, R = 0.497, p = 0.000.

Conclusions

In clinic practice, clearance rates of albumin, or calcium can be used to evaluate the quality of salvaged blood, fHb. Bed-side measurement of calcium could offer a more feasible means for clinicians to undertake a real-time assessment of fHb.

【 授权许可】

   
2014 Dong et al.; licensee BioMed Central Ltd.

【 图 表 】

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