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Original Articles: Adult Cardiac

Influence of Mechanical Cell Salvage on Red Blood Cell Aggregation, Deformability, and 2,3-Diphosphoglycerate in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass

^a Department of Biomedical Engineering, University Medical Centre Groningen, University of Groningen, the Netherlands
^b Department of Anesthesiology, University Medical Centre Groningen, University of Groningen, the Netherlands
^c Department of Cardiothoracic Surgery, University Medical Centre Groningen, University of Groningen, the Netherlands

Accepted for publication July 14, 2008.

^_* Address correspondence to Dr Gu, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, Groningen, 9713 AV, the Netherlands (Email: y.j.gu{at}med.umcg.nl).

Background: Mechanical cell salvage is increasingly used during cardiac surgery. Although this procedure is considered safe, it is unknown whether it affects the red blood cell (RBC) function, especially the RBC aggregation, deformability, and the contents of 2,3-diphosphoglycerate (2,3-DPG). This study examines the following: (1) whether the cell salvage procedure influences RBC function; and (2) whether retransfusion of the salvaged blood affects RBC function in patients.

Methods: Forty patients undergoing cardiac surgery with cardiopulmonary bypass were randomly allocated to a cell saver group (n = 20) or a control group (n = 20). In the cell saver group, the blood aspirated from the wound area and the residual blood from the heart-lung machine were processed with a continuous-flow cell saver before retransfusion. In the control group this blood was retransfused without processing. The RBC aggregation and deformability were measured with a laser-assisted optical rotational cell analyzer and 2,3,-DPG by conventional laboratory test.

Results: The cell saver procedure did not influence the RBC aggregation but significantly reduced the RBC deformability (p = 0.007) and the content of RBC 2,3-DPG (p = 0.032). However, in patients receiving the processed blood, their intraoperative and postoperative RBC aggregation, deformability, and 2,3-DPG content did not differ from those of the control patients. Both groups of patients had a postoperative drop of RBC function as a result of hemodilution.

Conclusions: The mechanical cell salvage procedure reduces the RBC deformability and the cell 2,3-DPG content. Retransfusion of the processed blood by cell saver does not further compromise the RBC function in patients undergoing cardiac surgery with cardiopulmonary bypass.

This article has been cited by other articles:

				Y. J. Gu, A. J. de Vries, J. A. M. Hagenaars, and W. van Oeveren Leucocyte filtration of salvaged blood during cardiac surgery: effect on red blood cell function in concentrated blood compared with diluted blood Eur. J. Cardiothorac. Surg., November 1, 2009; 36(5): 877 - 882. [Abstract] [Full Text] [PDF]