Influence of Mechanical Cell Salvage on Red Blood Cell Aggregation, Deformability, and 2,3-Diphosphoglycerate in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass

Leucocyte filtration of salvaged blood during cardiac surgery: effect on red blood cell function in concentrated blood compared with diluted blood

“…There are at least two reasons to explain why the concentrated blood is more susceptible to the filtration process. As we observed in this study as well as our previous reports [24], RBC deformability in the concentrated blood was significantly reduced by the cell saver process prior to leucocyte filtration. It is then possible that the cell saver process has made these RBCs more rigid.…”

Impaired Red Blood Cell Deformability After Transfusion of Stored Allogeneic Blood But Not Autologous Salvaged Blood in Cardiac Surgery Patients

“…16,26,32,42,43 Evidence also indicates that CPB adversely affects RBC structure and function, [23][24][25] and one study has shown functional changes in salvaged autologous RBCs tested in vitro, but not in blood sampled from patients after salvaged blood transfusion. 44 In our study, we found that neither salvaged RBCs nor CPB, when studied in combination, had a detrimental effect on RBC deformability. It is of note that earlier studies showing a 50-60% loss of deformability with CPB were performed with older technology, such as bubble oxygenators, which have been implicated in RBC damage and loss of deformability.…”

“…Other investigators have shown that RBC aggregation in processed autologous salvaged blood, both before and after transfusion, is associated with no changes in aggregation. 44 The changes that we measured were a transient decrease in aggregation that returned to baseline values by POD 1. We found no evidence of increased aggregation above baseline levels at any time point, an event that has been implicated in reduced blood flow in the microcirculation.…”

Residual blood processing by centrifugation, cell salvage or ultrafiltration in cardiac surgery

“…For deformability measurements, RBCs were elongated under various shear rates. The resulting elongation index is calculated from the ratio of the long and short axes of the different patterns of deformed RBCs at a shear rate of 3.89 Pa [13].…”

“…Low RBC aggregation not only alters microcirculatory perfusion, but may additionally trigger endothelial prothrombotic and pro-inflammatory responses [12,13]. Systematic evaluation of the effects of centrifugation, cell salvage and ultrafiltration on rheological parameters in the cardiosurgical setting is, however, lacking.…”