Journal Article Intraoperative Autologous Cell Salvage Can Induce Coagulopathy in Cardiopulmonary Bypass Surgery : An Ex-Vivo Study

Ogasawara, Takashi  ,  Minakawa, Masahito  ,  Kondo, Norihiro  ,  Suzuki, Yasuyuki  ,  Fukuda, Ikuo

66 ( 1 )  , pp.8 - 14 , 2015-04-06 , 弘前大学大学院医学研究科・弘前医学会
Objectives: The aim of this study is to investigate the effect of washed salvaged red blood cells on hemostasis in open heart surgery using the cardiopulmonary bypass( CPB). Methods: Nine patients were enrolled in this study. The cell salvage system was used throughout the surgery. Three blood samples( 1mL each) were obtained from each patient one hour after the CPB for the measurements consisting of control blood sample( Control group), 1.0ml of blood added with 0.2mL salvage blood( CS group) or 0.2mL normal saline (NS group). Test samples were evaluated using rotational thromboelastometry (ROTEM®). Coagulation was triggered by ellagic acid. Results: No significant differences were observed in the clotting time among the three groups. Clot formation time in the CS group and NS group was prolonged significantly compared with Control group (Control, 138±51; CS, 103± 28; NS, 135±48 sec). Amplitude of ROTEM® band at 10 minutes and maximum clot firmness in both the CS and NS group were significantly narrower than that of Control group. Conclusions: This ex-vivo study using ROTEM® suggested that the perioperative administration of washed salvagedred blood cells might have a potential to induce coagulopathy in cardiac surgery using the CPB.

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