Removal of activated complement from shed blood: comparison of high- and low-dilutional haemofiltration.

• BACKGROUND: Perioperative blood salvage is associated with release of inflammatory mediators. Depending on type of processing, the complement system is activated to some extent in the final blood product. The aim of the present study was to evaluate a haemofiltration technique concerning complement system activation and whether the volume of added saline will have an influence on the elimination of activated complement during processing. METHODS: Sixteen patients undergoing total hip arthroplasty received wound blood salvaged intraoperatively with a haemofiltration technique. Saline was added to the reservoir for washing in a ratio of 1:1 or 5:1 of estimated blood volume. Samples for determination of the anaphylatoxins C3a and C5a, and the terminal SC5b-9 complement complex (TCC) were drawn from the patients, the collected blood, the ultrafiltrate and the processed blood. RESULTS: Increased concentrations of C3a, C5a and TCC were found in aspirated and processed blood. Haemofiltration did not reduce the concentrations of these factors, except that of C3a in the group where saline was added in a ratio of 5:1. There were no increased concentrations of C3a, C5a or TCC in the patient plasma after reinfusion. No differences in blood pressure, heart rate, pH, arterial oxygen tension, arterial carbon dioxide tension, or base excess were found in association with reinfusion of the blood. CONCLUSION: Collected shed blood washed through haemofiltration contained moderately elevated concentrations of C3a, C5a and TCC. Reinfusion of the blood neither led to increased systemic concentrations of complement activation products, nor to disturbances in haemodynamic or biochemical parameters.

Nyckelord

Acid-Base Equilibrium

Aged

Anaphylatoxins

analysis

Arthroplasty

Replacement

Hip

Blood Loss

Surgical

Blood Pressure

physiology

Blood Transfusion

Autologous

Blood Volume

Carbon Dioxide

blood

Complement Activation

Complement C3a

analysis

Complement C5a

analysis

Complement System Proteins

analysis

Evaluation Studies

Female

Glycoproteins

analysis

Heart Rate

physiology

Hemofiltration

methods

Humans

Inflammation Mediators

blood

Intraoperative Care

Male

Middle Aged

Oxygen

blood

Plasma

Sodium Chloride

administration & dosage

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)