Premium
Fat removal during cell salvage: an optimized program for a discontinuous autotransfusion device
Author(s) -
Seyfried Timo F.,
Gruber Michael,
Breu Anita,
Aumeier Christoph,
Zech Nina,
Hansen Ernil
Publication year - 2016
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.13286
Subject(s) - autotransfusion , hematocrit , fat embolism , surgery , albumin , centrifugation , blood product , chemistry , medicine , chromatography , blood transfusion , biochemistry
BACKGROUND Fat in wound blood observed in orthopedic or cardiac surgery might pose a risk for fat embolism during blood salvage. Fat removal was optimized in the washing process. STUDY DESIGN AND METHODS In an experimental study blood from fresh donations was adjusted to a hematocrit (Hct) of 25% and an admixture of 1.25% human tissue fat. This blood was processed with the cell salvage device XTRA in a modified program mode. Volumetric quantification of fat was performed after centrifugation of blood samples in Pasteur pipettes. From the volumes, the Hct levels and the concentrations of fat and other variables elimination rates and RBC recovery were calculated. RESULTS Pretests showed wash volume, wash flow, and process interruptions affecting fat elimination. With the new optimized fat elimination program Pfat removal rate of fat increased to 98.5 ± 0.9% for the 225‐mL bowl. The product had a mean Hct of 48.7 ± 1.2% and a RBC recovery rate of 93.5 ± 2.3%. The program conserved the high elimination rates for albumin, heparin, potassium, and free plasma hemoglobin (98.8, 99.3, 95.3, and 94.9%, respectively). Similar high fat removal was also observed with bowls of smaller size, namely, 98.1% for the 175‐mL bowl and 98.2% for the 125‐ and the 55‐mL bowls. With test blood of Hct 10% a mean fat elimination of 99.6 ± 01% was observed. CONCLUSIONS A special program modification Pfat involving extra washing and RBC concentration steps significantly improves fat removal by the Latham bowl–based autotransfusion device XTRA, thus yielding results equivalent to the continuous cell salvage system.