ABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of acute hypervolemic hemodilution (AHH) and intraoperative blood salvage (IOBS) on the morphology and biomechanics of erythrocytes using atomic force microscopy (AFM).</p><p><b>METHODS</b>Blood samples were collected from 20 patients undergoing orthopedic surgery before operation (T1), immediately after AHH (T2), and after blood salvage (T3). AFM at nanometer resolution was used to examine the morphology and biomechanics of the collected erythrocytes.</p><p><b>RESULTS</b>The blood samples collected at T1 showed a significantly lower ratio of heteromorphous erythrocytes than those collected at T2 and T3 [(2.6∓1.3)% vs (19.3∓1.6)% and (17.6∓1.4)%, P<0.05]. AFM revealed significant differences in the morphology and biomechanics of the single erythrocyte in salvaged blood and blood after AHH compared with those of venous blood.</p><p><b>CONCLUSION</b>AHH and IOBS may cause significant changes in the morphology and biomechanics of erythrocytes in the salvaged blood.</p>