Effective of intraoperative blood salvage and reinfusion on coagulation
- VernacularTitle:异体与术中回收式自体输血对凝血功能影响的比较
- Author:
Yanping LI
;
Xudong WANG
;
Shuling PENG
- Publication Type:Journal Article
- Keywords:
Blood transfusion, autologous;
Blood transfusion;
Blood coagulation
- From:
Chinese Journal of Anesthesiology
1994;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the changes in blood coagulation induced by intraoperative blood salvage and reinfusion. Methods Thirty-six ASA I - II patients aged 15-63 yr undergoing elective major orthopedic surgery were paired according to their sex and type of surgery. The paired patients were randomly allocated to either autotransfusion group (study group) or homologous blood transfusion group (control group). Patients with malignant tumor were excluded. Anesthesia was induced with propofol, fentanyl and succinylcholine and maintained with isoflurane inhalation supplemented with intermittent iv boluses of fentanyl and vecuronium. During operation deliberate hypotension was induced with 0.01% sodium nitroprusside. Systolic blood pressure was maintained at (90?5) mm Hg or reduced by 30% of the baseline systolic blood pressure. During operation lactated Ringer' s solution was infused at a rate of 10 ml?kg-1?h-1 . In both groups, blood loss was replaced by equal volume of gelatine. Hct was maintained above 25% , CVP at 6 - 10 cmH2O and urine output above 50 ml? h-1 . In autotransfusion group, shed blood was collected and heparinized. Red cells were separated and washed for reinfusion. In control group red cell concentrate was infused. Hb, Hct, platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen concentration, and thrombin time (TT) were determined and thromboelastography (TEG) was performed before operation (T0 ), before blood transfusion (T1 ), 1 h after blood transfusion (T2) and 24 h after operation (T3) .Results The two groups were comparable with regard to age, sex, duration of operation, blood loss [ (1030 ?610) ml vs (989?586) ml] and the amount of crystalloid and colloid infused during operation. In autotransfusion group Hb decreased significantly after hemodilution. There was no significant difference in PT, APTT, FIB concentration and TT between the two groups. TEG showed that reaction time (r) increased significantly after hemodilution in autotransfusion group as compared with the preoperative baseline value (T0) but there was no significant difference in TEG parameters including r time between the two groups. Conclusion Intraoperative blood salvage and reinfusion induce no significant effects on blood coagulation as compared with allogenic blood transfusion.
