Impact of retransfusion of blood processed in cell-saver on coagulation versus cardiopulmonary bypass: a prospective observational study using thromboelastography.

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Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia Pub Date : 2015-03-01 Epub Date: 2013-03-22 DOI:10.5507/bp.2013.012

Tomas Vymazal, Martin Filaun, Michal Horacek

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引用次数: 5

Abstract

Aims: To compare an impact of retransfusion of blood processed in cell-saver (CS) with that of cardiopulmonary bypass (CPB) on blood coagulation in patients undergoing cardiac surgery.

Methods: Prospective observational study using thromboelastography (TEG).

Results: TEG samples from 170 patients were analyzed. Cardiopulmonary bypass was used in 100 patients while 70 patients were operated off-pump. In 20 off-pump patients collected blood was processed by cell-saver and returned. In all patients clot formation after heparin neutralization by protamine was unimpaired. However, there was a significant increase in fibrinolysis defined by the TEG parameter Lysis time 30 min after the maximum amplitude of the clot was reached (Ly30) in groups with CPB or CS but this increase still did not exceed the threshold for clinical fibrinolysis (Ly30 > 7.5%). In the group without CPB there was no significant impact on coagulation.

Conclusion: Surgery that avoids CPB and/or CS is the gentlest method for inducing blood coagulation.

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细胞保存器处理过的血液再输对凝血和体外循环的影响:一项使用血栓弹性成像的前瞻性观察研究。

目的:比较细胞保存器(CS)和体外循环(CPB)对心脏手术患者血液凝固的影响。方法:采用血栓弹性成像(TEG)进行前瞻性观察研究。结果:对170例患者的TEG样本进行了分析。体外循环100例，非体外循环70例。20例停泵患者采集的血液经细胞保存器处理后返回。在所有患者中，鱼精蛋白中和肝素后的凝块形成均未受损。然而，CPB组或CS组在血栓达到最大振幅(Ly30)后30min溶栓率(TEG参数)显著增加，但仍未超过临床纤维蛋白溶解阈值(Ly30 > 7.5%)。无CPB组对凝血无明显影响。结论:手术避免CPB和/或CS是诱导凝血最温和的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia

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