Direkte Autotransfusionssysteme liefern Blut unzureichender Qualität

Rosolski, T; Mauermann, K.; Frick, U; Herbert, Morley A.

doi:10.1055/s-2000-233

Cited by 14 publications

(8 citation statements)

References 6 publications

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“…The proponents of ADR, however, claim that unwanted substances are sufficiently removed by a filter system. We assessed three filter systems with regard to handling and effectiveness in patients undergoing total knee replacement [13]. Wound blood was examined before passage of the filter system and after passage of the ADR system.…”

Section: Quality Of the Blood Salvaged With Autologous Direct Transfumentioning

confidence: 99%

“…After transfusion of only 450 ml drainage blood -less than 10% of the blood volume -an increase of *Blood loss < 300 ml / 4 h. **Blood loss 300-1,000 ml / 4 h. Table 4. Comparison of drainage blood before and after filtration with three ADR systems [13] fibrin degradation products was observed up to 5 days after ADR. The D-dimer concentration was still increased 24 h after re-transfusion of the wound blood, indicating severe and sustained derangement of the hemostatic system (table 5).…”

Section: Effects Of the Re-transfusion Of Wound And Drainage Blood Onmentioning

confidence: 99%

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Autologous Direct Re-Transfusion – Contra

Roslski¹,

Mauermann²

2004

Transfus Med Hemother

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Direct re-transfusion of autologous blood (ADR) is a technique applied both intra- and postoperatively. Critical assessment reveals that this technique cannot fulfill expectations, particularly with respect to homologous blood avoidance. Undesired compounds delivered with such autologous re-transfusion systems result in – potentially lethal – complications. ADR is rarely indicated, provides blood of low quality, and produces hidden cost.

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Section: Quality Of the Blood Salvaged With Autologous Direct Transfumentioning

confidence: 99%

Section: Effects Of the Re-transfusion Of Wound And Drainage Blood Onmentioning

confidence: 99%

Autologous Direct Re-Transfusion – Contra

Roslski¹,

Mauermann²

2004

Transfus Med Hemother

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“…Unwashed wound or drainage blood cannot meet modern quality criteria in transfusion medicine because of its content of unfavorable substances originating from cytolysis and activation processes, and its content of destroyed and activated cells. -Quality of this blood is variable and usually bad [3]. -Contamination with unfavorable substances, i.e.…”

Section: Retransfusion Of Unwashed Wound and Drainage Bloodmentioning

confidence: 99%

Proposal for Internal Quality Management in Intra- and Postoperative Blood Salvage

Hansen¹,

Altmeppen²

2002

Transfus Med Hemother

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A proposal of an expert group is reported that was put forward to facilitate the set-up of a system for quality management in intra- and postoperative blood salvage. Retransfusion of unwashed blood is excluded since it cannot meet quality criteria of modern transfusion medicine. Quality assurance is necessary to guarantee the high quality of autologous blood prepared during blood salvage with cell washing. It includes a profound understanding of the composition of shed blood and the preparation process, a thorough documentation, and the measurement of quality control parameters. Process quality can be assessed in regular samples by evaluation of red blood cell recovery (>80%) and plasma wash-out efficiency (>90%). Microbiology testing of this unstored blood is not recommended in sterile procedures for lack of consequence. Product quality should be monitored by volume and hematocrit (>50%) during every application.

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“…Die meisten Autoren bewerten die Relevanz der Erythrozytenzerstörung als gering. Diese Einschätzung ist jedoch nicht ohne Widerspruch geblieben [28]. Als Risikofaktor wird insbesondere immer wieder die potentiell nephrotoxische Wirkung des freien Hämoglobins aufgeführt, wobei die klinische Relevanz jedoch ungeklärt ist.…”

Section: Eigenschaften Von Drainageblutunclassified

“…Letztendlich ist jedoch die klinische Bedeutung der gefundenen Ergebnisse nicht klar. Wenn auch die große Verbreitung und mittlerweile langjährige erfolgreiche Anwendung für die direkte Drainageblutretransfusion sprechen, gibt es in der neueren Literatur noch immer Arbeiten, in denen dieses Verfahren grundsätzlich abgelehnt wird [28]. Einige Autoren empfehlen daher Wundblut vor der Retransfusion zu waschen, wie es auch üb-licherweise bei der intraoperativen Sammlung von Wundblut mit maschinellen Autotransfusionssystemen durchgeführt wird.…”

Section: Nebenwirkungen Durch Drainageblutretransfusionunclassified