Quality Assessment Of Intraoperative Blood Salvage Using The Domestic3000P Cell Saver In Spinal Surgery

Objective:To evaluate the quality of intraoperative blood salvage in spinal surgery. Furthermore, to compare the quality of salvage blood using the domestic Jingjing3000P cell saver and import Haemonetics Cell Saver5+in spinal surgery.Methods:40patients undergoing elective spinal surgery were randomly divided into two groups:the group3000P used the3000P cell saver while the group CS5+used Haemonetics Cell Saver5+for intraoperative blood salvage. Each group had20patients. The red blood cell morphology before and after washing was observed, and the erythrocyte deformity rates in different groups were compared.2,3-DPG in RBC, conventional indices, blood gas, heparin and free hemoglobin were determined. What’s more, some of the indices were compared with the preoperative arterial blood and banked blood which was stored for more than three weeks in CPDA-1.Results:1. Compared with the preoperative arterial blood, the erythrocyte deformity rate of the unprocessed blood and processed blood in both two groups were markedly higher (p<0.01). Nevertheless, the erythrocyte deformity rate of the processed blood was significantly lower than unprocessed blood (p<0.01), and markedly lower than banked blood (p<0.01). No significant difference between the two groups in erythrocyte deformity rate (p>0.05).2. After processing the blood, the concentration of the2,3-DPG in red blood cell in processed blood was lower (p<0.01), but had no significant difference compared with the preoperative blood (p>0.05), and was still markedly higher than banked blood (p<0.01). No significant difference between the two groups in the concentration of the2,3-DPG in red blood cell (p>0.05).3. After processing, Hct of the processed blood in group CS5+and3000P were respectively38.9%±7.5%and34.7%±9.7%; Hb were respectively129.2±27.3g/l and114.8±27.4g/l; the free hemoglobin were respectively1.048±0.507g/l and1.147±0.432g/l; the heparin were respectively0.014±0.013IU/ml and0.016±0.011IU/ml; K+were respectively4.51±0.24mmol/l and4.67±0.32mmol/l.4. The red blood cell recovery rate in group CS5+and3000P were respectively77.14%±13.97%and74.62%±9.71%; the free hemoglobin removal were respectively95.46%±1.81%and95.53%±1.85%; the heparin removal were respectively99.77%±0.14%and99.62%±0.19%; K+removal were respectively84.49%±4.27%and84.69%±6.25%. There was no statistically significant between the two groups in the red blood cell recovery rate and impurity removal (p>0.05). Conclusions:1. The suction process had a profound influence on erythrocyte deformability. However, after processing the blood, the morphology of the harvest red blood cell was still good, and even much better than banked blood.2. Washing and centrifugation of the blood led to a decrease the concentration of the2,3-DPG in red blood cell in both two groups. However, the oxygen-carrying function of the processed blood was still good, and even much better than banked blood.3. The two cell savers can work well in spinal surgery,with good quality of red blood cells and high removal rates of FHb, heparin and K+. The processed blood met the clinical criteria.4. There was no different from the quality of intraoperative blood salvage between Jingjing3000P and Haemonetics Cell Saver5+in spinal surgery.