Auswaschverhalten von Lepirudin als Antikoagulans bei der maschinellen Autotransfusion mit dem cell-saver 5

Marx, Andreas; U, von Lüpke; Tessmann, R; Lindhoff-Last, Edelgard

doi:10.1055/s-2001-11816

Cited by 4 publications

(2 citation statements)

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“…Second, in patients with proven or suspected HIT intraoperative auto-transfusion is challenging. So far, lepirudin and danaparoid have been studied as anticoagulants for blood salvage systems, but at the moment both drugs are not broadly available [ 21 , 22 ]. Regional citrate anticoagulation might also be employed [ 16 , 23 ], but poses the risk of pH-disturbances.…”

Section: Discussionmentioning

confidence: 99%

Argatroban for anticoagulation of a blood salvage system - an ex-vivo study

et al. 2015

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BackgroundBlood salvage systems help to minimize intraoperative transfusion of allogenic blood. So far no data is available on the use of argatroban for anticoagulation of such systems.We conducted an ex-vivo trial to evaluate the effectiveness of three different argatroban doses as compared to heparin and to assess potential residual anticoagulant in the red cell concentrates.MethodsWith ethical approval and individual informed consent, blood of 23 patients with contraindications for use of blood salvage systems during surgery was processed by the Continuous-Auto-Transfusion-System (C.A.T.S. ® Cell Saver System, Fresenius Kabi, Bad Homburg, Germany) using 5,50 or 250 mg of argatroban or 25.000 U of heparin in 1000 ml saline for anticoagulation of the system. Emergency and high-quality washing modes were applied in random order. Patency of the system and residual amount of anticoagulants in the re-transfusion bag were measured. The collected blood was not re-infused, but only used for analysis of hematocrit, heparin and argatroban concentrations.ResultsPatency of the system was provided by all anticoagulants except for 3/8 cases with 5 mg of argatroban. Residual anticoagulant was found in 2/10 (20 %) heparin samples in two different patients (1 emergency and 1 high-quality washing) and in all argatroban samples. High quality washing eliminated 89–95 % and emergency washing 60–90 % of the initial argatroban concentration. Residual argatroban concentrations ranged from 55 ng ml−1 to 6810 ng ml−1, with initial argatroban concentrations of 5 and 250 mg, respectively.ConclusionThe C.A.T.S. does not reliably remove heparin and should therefore not be used in HIT patients. Anticoagulation with 50 and 250 mg argatroban, maintains the systems patency and is significantly removed during washing. In this ex-vivo study a concentration of 50 μg ml−1 argatroban provided the best ratio of system patency and residual argatroban concentration. Additional dose-finding studies with different blood salvage systems are needed to evaluate the optimal argatroban concentration.

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Section: Discussionmentioning

confidence: 99%

Argatroban for anticoagulation of a blood salvage system - an ex-vivo study

et al. 2015

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“…Intraoperative autologous blood recovery: Installing the piping system and blood recovery tank required for autologous blood transfusion as required, pre-fill the recovery tank and double-lumen suction tube with 100 to 200 mL of heparin water (heparin 12500U added to 500 mL of 0.9% sodium chloride solution), the ratio of dripping heparin water to recovered blood is 1:5, [10] so that 1 mL of recovered blood contains 5U of heparin sodium, the number of heparin saline drops is adjusted at any time with the speed and volume of blood recovered. The blood is recovered from trauma bleeding and gauze aspiration into the blood storage tank by negative pressure suction and the negative pressure is controlled at 120 mm Hg to 150 mm Hg.…”

Section: Methodsmentioning

confidence: 99%

Effect of intraoperative blood transfusion during maternal cesarean section on serum electrolytes and inflammatory response plus cellular immune response: A retrospective study

Xia,

2024

Medicine

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Analyzing the effect of intraoperative autotransfusion on serum electrolytes, inflammatory response and cellular immune response in puerperae undergoing cesarean section. This study is a retrospective study of 60 women who underwent cesarean section in our hospital from January 2022 to January 2023. The subjects were divided into 2 groups according to the blood transfusion mode of the patients. The differences in blood transfusion volume, blood transfusion volume, serum electrolyte, inflammatory response, cellular immune function, coagulation function and prognosis were compared between the 2 groups. The intraoperative blood transfusion volume, postoperative feeding time, the activity time since getting out of bed, the time of physical recovery and hospital stay in the observation group were lower compared to those of the control group, but the intraoperative crystal infusion volume and the colloid infusion volume in the observation group were higher compared to those of the control group (P < .05). Ca2+ concentrations of the observation group and the control group were lower compared with those of their same groups before surgery (P < .05), however, there were no statistically significant differences in the comparison of the Ca2+ concentrations between the observation group and the control group (P > .05). At 1d postoperatively, IL-1β, IL-6 and granulocyte-macrophage colony-stimulating factor (GM-CSF) were all higher (P < .05) and CD3+, CD4+ and CD4+/CD8+ were all lower (P < .05) in the observation group and the control group compared with those of their same groups before surgery. The IL-1 β, IL-6, and GM-CSF of the observation group were decreased compared to those of the control group (P < .05) and CD3+, CD4+, CD4+/CD8+ of the observation group were elevated compared to those of the control group (P < .05). Both autotransfusion and allogeneic blood transfusions during maternal cesarean section can attenuate the inflammatory response and have no significant inhibition of coagulation, and autotransfusion have less effect on the cellular immune response, are more effective in attenuating the inflammatory response, and significantly improve prognosis, although changes in Ca2+ concentration after transfusion require attention.

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Cell Salvage

2012

Basics of Blood Management

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Auswaschverhalten von Lepirudin als Antikoagulans bei der maschinellen Autotransfusion mit dem cell-saver 5

Cited by 4 publications

References 6 publications

Argatroban for anticoagulation of a blood salvage system - an ex-vivo study

Argatroban for anticoagulation of a blood salvage system - an ex-vivo study

Effect of intraoperative blood transfusion during maternal cesarean section on serum electrolytes and inflammatory response plus cellular immune response: A retrospective study

Cell Salvage

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