The Quality of Autotransfused Chest-Drainage Blood After Cardiac Surgery: a Study of Coagulation Factors

Abstract

A wide range of experience, dating back as far as 1978, has been gained with both the hard-shell cardiotomy reservoir of the heart-lung machine and the Sorensen autotransfusion System as retransfusion Systems. There remains, however, a lack of knowledge regarding the quality of retransfused blood in systems of less complex construction which are already available on the market and involve the use of a pouch (Sentinel-Seal autotransfusion System and Pleur-evac collecting System). The present study entailed the investigation of blood from the chest drainages of twenty patients after cardiac surgery by using a simple retransfusion System (Sentinel-Seal autotransfusion System). In two postoperative groups of patients with low and high blood loss from chest drainage, we determined, in addition to free plasma hemoglobin, the following: factor XII, kallikrein-like activity, thrombinantithrombin III complex, tissue-plasminogen and d-dimers. In the collective with a low blood loss, we found remarkable cell alterations as well as highly activated and advanced coagulation and an extraordinary fibrinolytic activity. If done at all, retransfusion by the Sentinel-Seal autotransfusion System should be restricted to the first four postoperative hours in cases of high blood loss.

Key words

Drainage blood - Cardiac surgery - Blood autotransfusion system