Suction conditions for minimizing the production of free hemoglobin during blood salvage using an autotransfusion apparatus

Abstract

BackgroundThree kinds of conditions should be considered to reduce free hemoglobin production using an autologous cell salvage device. They are the negative suction pressure, the size of suction tip, and the air contact during suction. We want to examine which condition is the most important factor to produce free hemoglobin.MethodsOne pack of red blood cell and one pack of fresh frozen plasma with the same blood type were mixed. They were aspirated based on the two suction pressure (-150 mmHg or -300 mmHg), three sizes of suction tips, and the two conditions of air contact, in which the suction tip was located in the surface of blood or in the middle of the blood. Seven ml sized EDTA tube was used to collect 5 ml blood. All the procedure repeated ten times. Free hemoglobin, total hemoglobin, and hematocrit were measured. Hemolysis ratio was calculated with following formula. Hemolysis ratio = (new free hemoglobin production) × (100-hematocrit) / (total hemoglobin).ResultsFree hemoglobin production and hemolysis ratio were increased when the suction tip was positioned in the surface than when it was in the middle of the blood. The pressure of negative suction and three kinds of the suction tips did not influence the production of free hemoglobin nor the hemolysis ratio.ConclusionsThe air contact is the most important factor to reduce hemolysis using autologous cell salvage device. Suction pressure or suction tip diameter have little influence to produce hemolysis.

Effects of cell salvage on erythrocyte 2,3‐disphosphoglycerate and G‐6‐PD levels and phosphatidylserine expression

“…Eliminating the hemolytic products by centrifuging and washing is crucial to improve salvaged blood quality. Previous studies have shown that when the suction tip is exposed to air, both fHb and rate of hemolysis increase . Thus, monitoring the fHb concentration is important to avoid renal injury.…”

“…Perioperative cell salvage performed via vacuum suction pressure method, centrifugal separation, and saline washes have little significant clinical benefit and promote RBC destruction . During the cell salvage process, air and debris, including small bone fragments, soft tissue, artificial operating materials, and microaggregates, may be mixed and suctioned together with the blood, which destroys RBC in salvaged blood . This occurrence causes an increase in free hemoglobin (fHb) and in the morphologic changes in the washed RBC , which consequently influences RBC function.…”

How would I establish a perioperative blood salvage program?

“…3 Autotransfused blood contains only RBCs and saline, although there may be a few contaminants if washing is not thorough. [3][4][5] In general, unlike banked blood, autotransfused units do not contain the plasma (including inflammatory mediators and clotting factors) or additives (e.g., citrate and phosphate buffer) that banked blood contains. 6 Also, autotransfused blood is typically reinfused at room temperature, rather than refrigerator temperature.…”

Pengaruh konsentrasi cobalt chromium pada uji hemolisis sebagai implan gigi

“…12 Hal-hal yang dapat menyebabkan hemolisis adalah defek eritrosit, infeksi, obat, zat kimia, transfusi, antibodi, kerja limpa berlebihan, toksik, dan mekanis.Gaya gesek eritrosit dengan material sebesar 150 Pa (1500 dynes/cm 2 ) dapat menyebabkan hemolisis. 13 Konsep biokompatibilitas telah menjalani perubahan dan menjadi perhatian para peneliti dalam beberapa tahun. Apabila sebelumnya perhatian biokompatibilitas adalah mengenai inertness, saat ini biokompatibilitas lebih dipertimbangkan dalam hubungan suatu material atau alat terhadap fungsi yang memuaskan.…”