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Quick biochemical markers for assessment of quality control of intraoperative cell salvage: a prospective observational study

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单位: [1]Capital Med Univ, Beijing Friendship Hosp, Dept Anaesthesiol, Beijing 100050, Peoples R China [2]Univ Birmingham, Perioperat Crit Care & Trauma Trials Grp, Birmingham B15 2WB, W Midlands, England
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关键词: Cell salvage Clearance rate Free haemoglobin Albumin Calcium

摘要:
Background: Intraoperative Cell Salvage (ICS), hereby referred to 'mechanical red cell salvage', has been widely used in adult elective major surgeries to reduce requirement for homologous red blood cell transfusion and its associated complications. However, amount of free haemoglobin (fHb) from ICS has been shown related to incidence of renal failure. fHb is the most important indicator of quality control of cell salvaged blood, thus monitoring the fHb concentration is imperative to minimise renal injury. However, currently there has been lacking quick biochemical markers to monitor the levels of fHb during ICS. The aim of this study was to screen quick biochemical markers for evaluating the amount of fHb during use of intraoperative cell salvage. Methods: Twenty patients undergoing elective cardiovascular surgery were enrolled. Blood was collected and processed using a Fresenius continuous auto-transfusion system device. The concentration of fHb, albumin (Alb), and calcium (Ca) in three washing modes were measured, and their clearance rates were calculated. The correlations among the clearances and concentrations of fHb, albumin, and calcium were analysed. Results: In three washing modes, concentrations of albumin and calcium are significantly associated with amount of fHb:fHb(g/L) = 0.111Alb(g/L) -0.108, R = 0.638, p = 0.000; fHb(g/L) = 1.721Ca(mmol/L) +0.091, R = 0.514, p = 0.000. Furthermore, the clearance rates of albumin and calcium significantly predict clearance of fHb, CRfHb = 0.310CR(ALB) + 0.686, R = 0.753, p = 0.000, CRfHb = 0.073 CR (Ca) + 0.913, R = 0.497, p = 0.000. Conclusions: In clinic practice, clearance rates of albumin, or calcium can be used to evaluate the quality of salvaged blood, fHb. Bed-side measurement of calcium could offer a more feasible means for clinicians to undertake a real-time assessment of fHb.

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出版当年[2013]版:
大类 | 4 区 医学
小类 | 4 区 心脏和心血管系统
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 心脏和心血管系统 4 区 外科
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出版当年[2012]版:
Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Q3 SURGERY

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2012版] 出版当年五年平均[2008-2012] 出版前一年[2011版] 出版后一年[2013版]

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第一作者单位: [1]Capital Med Univ, Beijing Friendship Hosp, Dept Anaesthesiol, Beijing 100050, Peoples R China
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通讯机构: [1]Capital Med Univ, Beijing Friendship Hosp, Dept Anaesthesiol, Beijing 100050, Peoples R China [*1]Capital Med Univ, Beijing Friendship Hosp, Dept Anaesthesiol, 95 Yongan Rd, Beijing 100050, Peoples R China
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