Autologous blood transfusion drainage and simple drainage after lumbar surgery: A comparative study / 中国输血杂志

【Objective】 To investigate the effect of autologous blood transfusion(ABT) drainage system and simple drainage(using drainage bags) on the prognosis of patients after lumbar surgery. 【Methods】 The patients admitted to the Department of Orthopedics of our hospital from August 2018 to September 2020 who underwent posterior open lumbar internal fixation and fusion were divided into two groups according to different drainage methods adopted after surgery: 50 patients were randomly selected from the patients who received postoperative ABT system for drainage as ABT group, and 50 patients were randomly selected from the patients who received postoperative drainage by drainage bag as simple drainage bgroup(the control group). The postoperative drainage volume, actual postoperative drainage, total dominant blood loss, total autologous blood transfusion volume, as well as the postoperative anemia indexes, infection indexes and albumin levels in d1, d3 and d7 of the 2 groups were retrospectively analyzed. 【Results】 The gender, age, operation duration and operation segment of the 2 groups were comparable (P>0.05), and preoperative Hb, Hct, ALB, WBC, NE%, intraoperative blood loss, intraoperative autologous blood transfusion volume and actual postoperative drainage volume were similar (P>0.05). There were no significant differences in Hb, Hct, ALB, WBC, NE% and CRP in postoperative d1, d3 and d7, as well as in preoperative and postoperative Hb, Hct and ALB, and in postoperative and preoperative WBC, NE% and CRP (P>0.05). The postoperative drainage volume (mL) and total dominant blood loss (mL) in ABT group and the control group were 554.40±176.82 vs 337.80±102.43, and 1 048.40±282.87 vs 791.80±277.02, respectively (P<0.05). 【Conclusion】 The use of ABT drainage system after lumbar surgery increased the drainage volume compared with simple drainage, but the improvement of anemia, albumin and infection was not obvious. ABT system should not be used routinely for drainage after lumbar surgery.

Autotransfusão imediata em cão - relato de caso / Instant autotransfusion in dog - case report

As hemorragias podem levar à morte, em caso de não interrupção e recuperação da volemia. A substituição do sangue pode ser realizada por transfusão homóloga ou autóloga. Na transfusão homóloga, o sangue é obtido de um doador, na autotransfusão ou transfusão autóloga, o sangue é coletado do próprio paciente. Objetivou-se relatar a autotransfusão em um cão como um método simples, rápido e barato, e discutir esse procedimento como uma alternativa emergencial para clínicas e hospitais que não possuem bancos de sangue ou animais doadores. Foi atendido um cão Rottweiler fêmea, 42,8kg, 10 anos de idade, com queixa principal de tumor mamário e para realização de castração. Após o procedimento, a paciente apresentou hemoperitônio, sendo encaminhada para novo procedimento cirúrgico, durante o qual se observou grande quantidade de sangue livre na cavidade abdominal. Foi realizada a autotransfusão de emergência, pela técnica das duas seringas, devido à indi1111sponibilidade de sangue ou animal doador no momento do procedimento cirúrgico emergencial, demonstrando ser uma opção eficiente, econômica, de fácil acesso e segura, por ser uma transfusão normotérmica, apresentar diminuição do risco de sobrecarga circulatória e por ser o sangue compatível, devendo ser mais explorada, pois existem poucos dados descritos na literatura.(AU)

Hemorrhages can lead to death in case of non-interruption and recovery of blood volume. Blood replacement may be performed by homologous or autologous transfusion. In homologous transfusion, blood is obtained from a donor, in autotransfusion or autologous transfusion, blood is collected from the patient himself. We aimed to report autotransfusion in a dog as a simple, quick, and inexpensive method, and discuss it as an emergency alternative for clinics and hospitals that do not have blood banks or animal donors. A female Rottweiler dog, 42.8kg, 10 years of age, was treated with a primary complaint of mammary tumor and for castration. After the procedure the patient presented hemoperitoneum, being referred to a new surgical procedure, where a large amount of free blood was observed in the abdominal cavity. The emergency autotransfusion was performed by the two syringes technique, due to the unavailability of blood or donor animal at the time of the emergency surgical procedure, proving to be an efficient, economical, easily accessible and safe option because it is a normothermic transfusion, risk of circulatory overload and blood is compatible. It should be more exploited because there are few data described in the literature.(AU)

Feasibility of application of umbilical cord blood autologous transfusion in intrapartum and neonatal surgery / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the feasibility of the application of autologous umbilical cord blood transfusion in intrapartum neonatal surgery.METHODS: From August 2008 to December 2018,15 cases of birth defects diagnosed in Shengjing Hospital affiliated to China Medical University who had received prenatal or neonatal surgery and had cord blood retained for autologous transfusion were selected.Routine biochemical tests were performed on the retained cord blood and the peripheral blood of the children before transfusion,follow-up was conducted on the postoperative infants with autologous blood transfusion,and blood routine tests and other relevant postoperative indicators,such as length of hospital stay and duration of intravenous nutrition support,were tested.RESULTS: Comparing the routine blood test of umbilical cord blood of the fetuses with that of the peripheral blood of neonates,there was no obvious statistical difference in the number of red cells[(4.15 ± 0.35)× 1012/L,(4.39 ± 0.31)× 1012/L,P=0.069],erythrocyte deposited[0.4749±0.047,0.5072±0.0367,P=0.052],thenumberofhemoglobin[(156.67±13.28)g/L,(166.47±13.73)g/L,1012/L,P=0.391].No adverse reactions were observed after umbilical cord blood transfusion.After transfusion,hemoglobin reached the predetermined indexes,and no second transfusion was performed.CONCLUSION: The index of autologous umbilical cord blood is basically the same as that of neonatal peripheral blood,and it is simple,easy and cheap,which avoids the adverse reaction of allogeneic adult blood transfusion;there was no adverse prognosis.Therefore,it can be used for neonatal blood transfusion preparation.

Implementation of an obstetric cell salvage service in a tertiary women's hospital

<p><b>INTRODUCTION</b>Intraoperative cell salvage (ICS) is an important aspect of patient blood management programmes. An ICS service was introduced at KK Women's and Children's Hospital, Singapore, from 2 May 2011 to 30 April 2013 to aid in the management of massive obstetric haemorrhage.</p><p><b>METHODS</b>With support from the Ministry of Health's Healthcare Quality Improvement and Innovation Fund, a workgroup comprising obstetricians, anaesthetists and nursing staff was formed to develop training requirements, clinical guidelines and protocols for implementing ICS using the Haemonetics Cell Saver 5. Pregnant women with an anticipated blood loss of > 1,000 mL during Caesarean delivery, a baseline haemoglobin level of < 10 g/dL, rare blood types and who had refused donor blood were recruited to the service after obtaining informed consent.</p><p><b>RESULTS</b>A total of 11 women were recruited to the ICS service; the primary indications were placenta praevia and placenta accreta. Median blood loss in these 11 patients was 1,500 (range 400-3,000) mL. In four patients, adequate autologous blood was collected to initiate processing and salvaged, processed blood was successfully reinfused (mean 381.3 [range 223.0-700.0] mL). Median blood loss among these four patients was 2,000 (range 2,000-3,000) mL. No adverse event occurred following autologous transfusion. Mean immediate postoperative haemoglobin level was 8.0 (range 7.1-9.4) g/dL.</p><p><b>CONCLUSION</b>The implementation of an obstetric ICS service in our institution was successful. Future studies should seek to address the cost-effectiveness of ICS in reducing allogeneic blood utilisation.</p>

The Efficacy and Safety of Autologous Transfusion in Unilateral Total Knee Arthroplasty

PURPOSE: Although allogeneic blood transfusion is the most common method of transfusion in total knee arthroplasty (TKA), there are reports showing significant decrease in the amount of allogeneic transfusion and incidence of side effects after combined use of autologous transfusion. The purpose of this study is to investigate the efficacy of using an autologous transfusion device in TKA. MATERIALS AND METHODS: Patients who underwent TKA at our institution from January 2003 to January 2014 were divided into two groups: group A (n=127) who received allogeneic transfusion only in TKA and group B (n=118) who received autologous transfusion via an autologous transfusion device and allogeneic transfusion. In both groups, the patients were transfused when the hemoglobin level was below 9 g/dL. In group B, blood collected by the autologous transfusion device was transfused only once after surgery. The total blood loss volume, total transfusion volume, and the presence of side effects were assessed based on medical records. RESULTS: Group A received 294.6 mL more allogeneic transfusion than group B (p<0.001). There were no significant differences with regard to the development of side effects between groups. CONCLUSIONS: Application of an autologous transfusion device during TKA can be effective in reducing the allogeneic transfusion volume. Moreover, allogeneic transfusion was not necessary after autologous transfusion in some patients.

Autologous transfusion of drained blood from abdomen for conservative treatment of blunt trauma of spleen / 中华急诊医学杂志

Objective To study the safety and feasibility of auto-transfusion of blood drained from patients own abdomen in patients with blunt trauma of spleen as conservative treatment.Methods From January 1,2008 to December 31,2010,94 patients were diagnosed to be blunt trauma of spleen.After careful assessment and series lab tests,44 patients were eligible to be non-operative treated.They were randomly (random number) into two groups in equal number (n =22).The patients of auto-transfusion group were transfused the blood drained from patients own abdomen,and the control group was transfused red blood cells from donors.The comparison of demographics,ISS (injury severity scores),AAST (American Association for the Surgery of Trauma) and lab findings between two groups before and after transfusion with t test and chi-square test.Then paired-samples t test was used to analyze the hemodynamics,blood components and blood clotting indexes of two groups before and after blood transfusion.Meanwhile t test was done as well to compare the differences in the above variables between two groups after transfusion.SPSS 10.0 version was used to analyze the collected data.Results There were no significant differences in demographics and physical condition between two groups.After blood transfusion,the hemodynamics and anemia of two groups were significantly improved,and there were no differences in the changes of the above variables between two groups.Conclusions Blood drained from patient own abdomen can be auto-transfused in patients with blunt trauma of spleen treated non-operatively as safe and efficient as transfusion of blood from donors.This study proves the autologous transfusionto to be an easy,feasible and economic measures in urgent situation as expected.

Evaluation of Quality of Intraoperative Salvaged Red Blood Cells Processed by CATS(Plus) / 대한수혈학회지

BACKGROUND: CATS(Plus) (continuous autotransfusion system, Fresenius Kabi, Friedberg, Germany) is a continuous, chamber type cell salvage system for performing an intraoperative autologous transfusion. We evaluated the quality of intraoperative salvaged red blood cells processed by CATS(Plus). METHODS: A total 20 adult patients undergone lumbar spine surgery were enrolled in this study. Laboratory tests including albumin, potassium, free hemoglobin, and bacterial culture were performed and the % albumin removal was calculated. RESULTS: The average albumin, potassium, and free hemoglobin concentration were 4 g/L, 4.86 mEq/L, 4.50 g/L, respectively. Mean albumin removal was 87%. Bacterial culture was positive in 11 of the 20 cases and staphylococcus species were isolated in all of the culture positive cases. CONCLUSION: For safe use of salvaged red blood cells, laboratory tests for potassium and free hemoglobin concentration would be necessary before administration.

Availability of autologous transfusion in bilateral sagittal split ramus osteotomy for mandibular prognathism

OBJECTIVE: Autologous transfusion is frequently used with orthognathic surgery. The necessity of autologous transfusion has begun to question alone in bilateral sagittal split ramus osteotomy. The aim of this study was to evaluate the availability of autologous transfusion. METHODS: The chart reviews of sixty patients who had undergone bilateral sagittal ramus osteotomy were done. The subjects were divided into two groups : In experimental group, 30 patients who autodonated 320ml in the preoperative 3 weeks actually received a transfusion in the postoperative 6 hours were included. In control group, 30 patients who underwent the same operation without preoperative donation and any other transfusion were included. Hemoglobin, hematocrit, and changes of these values in both groups were evaluated. RESULTS: 1. From postoperative 3 hours to postoperative 1 day, the increases of hemoglobin(0.8g/dL in experimental group, 0.2g/dL in control group) and hematocrit(0.3% in experimental group, 0.6% in control group) were not statistically significant between both groups. 2. From postoperative 1 day to postoperative 1 week, the increase of hemoglobin(0.6g/dL in experimental group, 0.3g/dL in control group) was not statistically significant between both groups. But the increase of hematocrit(2.5% in experimental group, 1.0% in control group) was statistically significant between both groups over the same period(hematocrit p=0.043). 3. On postoperative 1 week, the values of hemoglobin(12.3% in both groups) and hematocrit(35.6% in experimental group, 36.8% in control group) were not statistically significant between both groups. CONCLUSION : The autologous transfusion in surgery of just a little blood loss was not effective. The most results show that there is little availability of autologous transfusion according to changes of hemoglobin and hematocrit in bilateral sagittal split ramus osteotomy.

A Comparison of Autologous and Homologous Transfusions in Spinal Fusion

Autologous transfusion has been used to overcome adverse effects of homologous transfusion. Clinical studies evaluating general orthopaedic postoperative results have been designed to compare these transfusion methods. However, few studies have evaluated postoperative results in spinal fusion surgeries, which have larger blood loss volumes. The purpose of this study is to determine if there are differences in postoperative infection and clinical results of spinal fusion with autologous, as compared to homologous, blood transfusion. A total of 62 patients who underwent instrumented spinal fusion and received autologous (n = 30) or homologous (n = 32) transfusions were reviewed. Information on gender, age, preoperative and 3-day postoperative hematologic features, total transfused units, segmental estimated blood loss, transfused units, and surgery time were collected. In addition, postoperative infection data on wound infection, pneumonia, urinary tract infection, cellulitis, and viral disease, incidence and duration of fever, as well as clinical results, fusion rates, and patient feedback were collected. No differences in postoperative infection and clinical results were found between the two types of transfusions; however, homologous transfusion was associated with an increased number of total units transfused, longer duration of fever, and decreased patient satisfaction regarding the transfusion.

A Comparison of Autologous and Homologous Transfusions in Spinal Fusion

Autologous transfusion has been used to overcome adverse effects of homologous transfusion. Clinical studies evaluating general orthopaedic postoperative results have been designed to compare these transfusion methods. However, few studies have evaluated postoperative results in spinal fusion surgeries, which have larger blood loss volumes. The purpose of this study is to determine if there are differences in postoperative infection and clinical results of spinal fusion with autologous, as compared to homologous, blood transfusion. A total of 62 patients who underwent instrumented spinal fusion and received autologous (n = 30) or homologous (n = 32) transfusions were reviewed. Information on gender, age, preoperative and 3-day postoperative hematologic features, total transfused units, segmental estimated blood loss, transfused units, and surgery time were collected. In addition, postoperative infection data on wound infection, pneumonia, urinary tract infection, cellulitis, and viral disease, incidence and duration of fever, as well as clinical results, fusion rates, and patient feedback were collected. No differences in postoperative infection and clinical results were found between the two types of transfusions; however, homologous transfusion was associated with an increased number of total units transfused, longer duration of fever, and decreased patient satisfaction regarding the transfusion.

Effect of Autologous Blood Transfusion on Postoperative Levels of IL-6,IFN-?,and TNF-? after Spinal Operation / 中国微创外科杂志

Objective To compare the effect of allogeneic and autologous blood transfusion on postoperative immunoreaction in patients after spinal surgeries.Methods A total of 44 patients undergoing spinal operations were randomly divided into two groups.Allogeneic (n=22) or autologous (n=22) buffy-coat-depleted red cells were used in the patients during the operations.The serum levels of IL-6,IFN-?,and TNF-?were determined preoperatively and then re-measured 1 and 7 days after the operations. Results In theautologous group,both IFN-?and IL-6 increased after the oprerations,the level of IL-6 was significantly higher than that in the allogeneic group at days 1 and 7.The concentration of TNF-?did not change after the surgeries in the two groups. Conclusions By autologous blood transfusion,the serum levels of IFN-?and IL-6 can be increased significantly after spinal operation,meanwhile the concentration of TNF-?remains stable.The postoperative inhibitory effect of the procedure on immunocytokines is significantly weaker than that of allogeneic blood transfusion,indicating that autologous blood transfuion can protect or even increase immunofunction after spinal operation.

Study for Determination of the Safe and Efficient Collection Volume in Preoperative Autologous Blood Deposit / 대한수혈학회지

BACKGROUND: In the preoperative autologous blood deposit, total hemoglobin mass in one unit of autologous blood is various among the donors and the extents of hemoglobin increase following autologous transfusion may vary with the donor. Therefore, the authors intended to establish the standard of collection volume in preoperative autologous blood deposit, in order to warrant the safety of donor and gain the efficient increase of hemoglobin. METHODS: We performed a study of the following on 236 autologous donors (116 adult males and 120 adult females): collection of fixed blood volume (320 or 400 mL), collection of fixed hemoglobin mass (40, 45, 50, and 55 g) for one unit of blood, collection of blood volume to increase as much hemoglobin as 1 g/dL following autologous transfusion. RESULTS: The most safe and efficient collection method for preoperative autologous blood deposit is the collection of 400 mL of blood or collecting blood up to 55g of hemoglobin mass for male, and up to 45g of hemoglobin mass for female in one unit. CONCLUSION: These results are considered better methods for preoperative autologous blood deposit than routine collection of 320 mL of blood volume, irrespective of gender.

Effect of Acute Normovolemic Hemodilution on Postoperative Allogenic Blood Requirement after Total Knee Arthroplasty / 대한마취과학회지

BACKGROUND: Acute normovolemic hemodilution (ANH) is recognized as the easiest, the most economical and valuable autologous blood saved method among the types of autotransfusion. We studied whether this method could reduce the transfusion requirement of allogenic blood in total knee arthroplasty to investigate the efficacy of ANH. METHODS: The thirty patients were randomized and divided into two groups. In the ANH group (n = 15), 2 units of autologous blood were procured from a CVP catheter immediately before or after anesthetic induction, while Ringer's lactate and colloid solution were infused to maintain normovolemia via a different venous catheter. Perioperative changes of hemoglobin, hematocrit, platelets, prothrombin time (PT), transfusion requirements and the amount of postoperative drainage were compared. RESULTS: There were no significant difference between the two groups in terms of perioperative changes of hemoglobin, hematocrit or platelets. And, there was significantly reduced demand for packed RBC transfusion in the ANH group (362.7+/-236.4 ml) compared with the control group (668.0+/-259.3 ml) (P <0.05). However, no significant difference was observed between the two groups in terms of postoperative drainage amount. CONCLUSIONS: ANH can reduce transfusion requirements in total knee arthroplasty surgery if this is accompanied by appropriate patient selection and monitoring.

Anesthetic Experience during Liver Transplantation in a Pediatric Jehovah's Witness: A case report / 대한마취과학회지

We report the case of an 11-month-old Jehovah's Witness girl with end-stage liver disease secondary to biliary atresia who underwent a successful living-related liver transplantation. The donor was her mother who is a member of Jehovah's Witness. The use of recombinant human erythropoietin increased hemoglobin concentrations during the perioperative period. Intraoperatively, meticulous surgical hemostasis, avoidance of hypothermia, minimal blood sampling, administration of tranexamic acid, and return of the blood scavenged from the operative field by intraoperative blood salvage enabled the completion of the operation without the use of blood products.

Autologous blood transfusion in the third trimester of pregnancy / 대한산부인과학회잡지

OBJECTIVE: Preoperative autologous blood donation aims at avoiding the risks associated with exposure to allogenic blood and transfusion related diseases such as AIDS and hepatitis. While its use is frequent in adult patients with elective surgery, it is still uncommon in pregnant women because its safety has not been established for mother and fetus. The aim of this study is to determine the safety and utility of autologous blood donation in the third trimester of pregnancy. METHODS: In this study, sixteen pregnant women with placenta previa, Rh negative or huge myoma underwent 24 phlebotomies according to an autologous transfusion program. Phlebotomies were performed at an average gestational age of 36+4 weeks (range 34-41 weeks). Maternal vital sign and fetal heart rate were monitored before, during and after phlebotomy. Hematocrit was statistically evaluated by paired t-test. RESULTS: During the phlebotomy, there was no remarkable change in fetal heart rate except one case with temporary fetal tachycardia. Furthermore, changes in mean maternal diastolic blood pressure and pulse rate were not noted except one case with mild dizziness and diaphoresis. Change in mean maternal hematocrit between the initial donation and admission day for delivery was not statistically significant (P>0.05). The average interval from last donation to delivery was 9.8 day (2-20 day). Fetal outcomes were good in all cases. CONCLUSION: We concluded that preoperative autologous blood donation in pregnant woman in third trimester is safe for mother and fetus. So, if pregnant woman do not want to receive allogeneic transfusion, autologous blood transfusion might be the alternative method.

Autologous Frozen-thawed Blood Transfusion in the Bone Marrow Donors / 대한수혈학회지

BACKGROUND: The cryopreservation of Red Blood Cells have been proved to have many advantages in western countries. However, in Korea, clinical application of frozen-thawed blood is still in its early stage. We tried autologous frozen-thawed blood transfusion and evaluated the effects and complications. METHODS: Nine units of whole blood were collected from the autologous (n=1) and allogeneic bone marrow donors (n=3) and made packed RBCs by a centrifugation method. We made frozen RBCs using high glycerol method and stored them in -80degrees C freezer for 1 month. Eight units of frozen RBCs were thawed and washed by Cobe spectra (Cobe, USA). Autologous transfusions were done to the patient and donors while the bone marrow collection procedures were in process for bone marrow transplantation and we carefully observed its effects and complications. RESULTS: The mean RBC recovery rate were 89.8% and the supernatant plasma hemoglobin, K+, LD, osmolality, and simulation test were satisfactory to the allowable limit. After transfusion, the hemoglobin value was significantly elevated being comparable to that of the fresh blood. A case showed mild hematuria related to this transfusion but soon it disappeared in a day. CONCLUSION: The autologous frozen-thawed blood transfusions were safe and as much effective as the fresh blood. It would be essential to have skillful techniques in post-thaw washing process.

Prebanked Autologous Transfusion using Recombinant Human Erythropoietin: Report of one case / 대한정형외과학회잡지

In the orthopaedic field, some elective surgery such such as joint replacement, spinal surgery and limb sparing procedures for musculoskeletal tumors frequently need various amounts of blood trans- fusion. But homologous transfusion occasionally result in various side effect including allergic reaction, febrile reaction, coagulopathies due to reduced platelets and coagulating factors, graft versus host disease(GVHD) and transmission of infectious diseases such as malaria, syphilis, hepatitis and AIDS. Recently these complications especially in elective surgery might result in medicolegal and social problem. Risks of transfusion could be minimized with autologous blood. So many authors are interested in prebanked autologous transfusion in elective orthopaedic surgery to prevent these problems. But there might be need of additional homologous blood transfusion because of the time limited and low yield of autologous blood. Recombinant human erythropoietin(4-HuEPO) has been shown to increase erythropoiesis. The authors could yield 5 units during 14 days using r-HuEPO without any adverse reactions. Therefore we could performed decompression, posterolateral fusion with pedicular screw fixation in spondylolisthesis without additional homologous transfusion.

The Effects of Acute Hemodilution and Autologous Transfusion on Usages of Homologous Transfusion and Blood Loss during Open Heart Surgery / 대한마취과학회지

To evaluate the safety and effectiveness of the intraoperative phlebotomy with acute hemodilution and autologous transfusion as an approach to blood conservation during cardiac operation, 126 patients were grouped into autologous transfusion group(Group I, n=54), prospective control group(Group II, n=22), and retrospective control group(Group III, n=50). Intraoperative hemodilution was practiced in autologous transfusion group before extracorporeal circulation. After an extracorporeal circulation, the units of blood phlebotomized were transfused. Hematocrit, platelet count, PT(prothrombin time), PTT(partialthromboplastin time), MAP(mean arterial pressure), and amount of homologous transfusion were measured immediately after induction, during bypass, and at the intensive care unit. Blood loss was measured at 12 hours and 24 hours after arrival at intensive care unit. Incidence of hemologous transfusion was 62% in group I, 86.4% in group II, and 100% in group III. Patients received 2.2+/-0.4 units in group I, 4.1+/-0.8 units in group II and 6.7+/-0.5 units in group III. Coagulation studies showed no significant improvement in autologous transfusion group who received fresh autologous blood. There was no difference in blood loss postoperatively among 3 groupes. In conclusion, our data suggest that the use of autologous transfusion with hemodilution reduces usage of homologous blood in all cardiac surgery procedures.

Postoperative autotransfusion using a blood drainage and transfusion device, ConstaVac, in patients with total knee replacement / 대한마취과학회지

ConstaVac (Stryker, Michigan, U.S.A.), a blood drainage and transfusion device, was applied to transfuse the autologous blood from the wound in 20 patients undergoing total replacement under the spinal anesthesia To evaluate the hemodynamic states, direct arterial blood pressures and central venaus pressures were monitored. Before touniquets release, 500-1000 ml of 10% pentastarch were infused rapidly to prevent hypovolemia until the driining reservior bag was filled to at least 40 ml. During all the procedures the mean arterial pressures were main-tained at about 80 mmHg, even if tbose after the induction of anesthesia were lower tban those at the preanesthetic period. The average amounts of blood loss were 942 ml and 2240 ml in unilateral and simultaneous bilateral surgery, respectively. The average amounts of blood that were salvaged after unilateral and simultaneous bilateral knee arthroplasty were 1113 and 2918 ml, respectively. Until 7 posto-perative days, thrombocytopenia and anemia were developed in one and three cases, respectively. We concluded that the use of the ConstaVac in the immediate postoperative period is a useful and practical method of autologous transfusion and conservation of a previous resource, and we recommend its use especially in simultaneous bilateral knee arthroplasty.

Intraoperative Salvage in Open Heart Surgery / 대한마취과학회지

For autologous transfusion, intraoperative salvage technique with Cell Saver Apparatus was used in open heart surgery. Seventy-eight patients were involved in this study and divided into two groups. They were group of salvage(n=58) and non-salvage(n=20). In each group, they were also divided into four groups of CHD(who underwent surgery of congenital heart disease), UNDO(who underwent first-valvular surgery or repair of dissecting aneurysm), REDO(who underwent redo-valvular surgery) and CABG(who underwent coronary artery bypass surgery) according to the degree of blood loss during surgery. Amount of blood obtained from Cell Saver Apparatus was 811+/-273(mean+/-std) ml. Hematologic profile of blood from this apparatus was as follows, 1) Hemoglobin: 18.2+/-2.0(g/dl), 2) Hematocrit: 52.8+/-5.6(%), 3) Platelet: 35K+/-21K (mm). The hank blood utility ratio{No. of patients who used hank blood (No. of patients who used bank blood+who didnt use bank blood)x100(%)) tended to increase in non-salvage group and statistically significant(p< or =0.05) only in CHD group(non-salvage group vs. salvage group= 63% vs. 17%). And the amount of bank blood transfused tended to be higher in non-salvage group than salvage group and statistically significant(p< or =0.05) only in CHD group. This study suggested that intraoperative salvage technique with Cell Saver Apparatus could decrease the use of bank blood in open heart surgery.