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Anesth Analg 2007;104:684-687
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000255208.96685.2e


GENERAL ARTICLE

Modification of Suction-Induced Hemolysis During Cell Salvage

Jonathan H. Waters, MD*, Brandon Williams, BS{dagger}, Mark H. Yazer, MD, FRCPC{ddagger}§, and Marina V. Kameneva, PhD{dagger}||

From the *Department of Anesthesiology, Magee Womens Hospital of University of Pittsburgh Medical center; Departments of {dagger}Bioengineering and {ddagger}Pathology, §The Institute for Transfusion Medicine; and ||McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA.

Address correspondence and reprint requests to Jonathan H. Waters, MD, Department of Anesthesiology, Magee Womens Hospital of University of Pittsburgh Medical Center, 300 Halket St., Suite 3510, Pittsburgh, PA 15213. Address e-mail to watejh{at}upmc.edu.

BACKGROUND: The efficiency of red blood cell collection during cell salvage is dictated by multiple variables, including suction pressure. In this study, we attempted to determine the influence of suction pressure on the efficiency of cell salvage and to identify methods for minimizing the impact of suction on salvaged blood.

METHODS: Whole blood was placed in 60-mL aliquots either in a beaker or on a flat surface and suctioned at 100 and 300 mm Hg. The amount of hemolysis was measured and compared under the varying conditions. The experiments were repeated with the blood diluted with normal saline solution in a 1:1 mix.

RESULTS: Hemolysis ranged from 0.21% to 2.29%. Hemolysis was greatest when whole blood was suctioned from a flat surface at 300 mm Hg. It was reduced when the blood was diluted with saline. Blood suctioned from a surgical field during cell salvage should be done with minimal suction pressures and with the goal of minimizing blood–air interfaces.

CONCLUSIONS: Significant reduction of blood damage can be obtained by diluting blood with normal saline while suctioning it from the surgical field. Although immediate hemolysis due to suctioning was not very high, the red blood cell damage from suctioning produced by a dynamic blood–air interface might adversely affect the efficiency of cell salvage.







Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.