Study Of Protective Effects Of Edaravone On Washed Erythrocytes During Blood Salvage

ObjectiveTo investigate the protective effects of edaravone on washed erythrocytes duringblood salvage and explore its underlying mechanism.MethodsForty patients scheduled for elective spine surgery were randomly divided into2groups（n=20each）: edaravone group（E group） and control group（C group）.Patients inthe E group received0.5mg/kg edaravone intravenously30minutes beforeoperation.Then edaravone was added into the anticoagulant heparin saline and thewash saline up to the concentration of3μg/ml.The control group was given the sameamount of normal saline.Peripheral venous blood and salvaged blood samples wereanalyzed for superoxide dismutase（SOD）、 glucose-6-phosphate dehydrogenase（G6PD）、malondialdehyde（MDA）、Na⁺，k⁺-ATPase、Ca²⁺，Mg²⁺-ATPase、erythrocyteosmotic fragility、 mean corpuscular volume（MCV）、 hematocrit（HCT）、hemoglobin（Hb） and free hemoglobin（FHb）.The blood volumes in the collectionreservoir and holding bag were also recorded.The red blood cell recovery rate was calculated using the following equation:Recovery rate（%）=（Vw×HCTw）/（Vs×HCTs）×100%,where W means washed and S means suction.Results1.The patients’demographics,operation time,blood loss,and the amount ofsalvaged blood have no statistically significant difference between the twogroups.2.There were no significant differences with regards to SOD、G6PD、MDA、Na⁺，k⁺-ATPase、Ca²⁺，Mg²⁺-ATPase、erythrocyte osmotic fragility、MCV、FHb、Hb、HCT in the peripheral venous blood between the two groups.3.As compared to venous blood,no significant difference existed on erythrocyteosmotic fragility in both groups. The SOD、G6PD、Na⁺，k⁺-ATPase and Ca²⁺，Mg²⁺-ATPase values of red blood cells were lower while the MDA、MCV、FHb levels increased in recovered blood in group C when in comparison withvenous blood.Edaravone caused significant increases in SOD、G6PD、Na⁺，k⁺-ATPase and Ca²⁺，Mg²⁺-ATPase levels,as well as reduction in MDA、MCV and FHb.4.The values of Hb、HCT in salvaged blood and the red blood cell recovery ratewere significantly higher in group E than that in group C.Conclusions1.Blood salvage can lead to free radical production and cause an imbalancebetween oxidation and antioxidation.This process reduces SOD and G6PDlevels,decreases Na⁺，k⁺-ATPase、Ca²⁺，Mg²⁺-ATPase activity and increasesMCV、MDA of red blood cells.Extensive hemolysis is also observed in thecollected blood with increased FHb generation.2.Edaravone can scavenge free radical,increase SOD、G6PD levels and decreaseMDA production.It can also prevent lipid peroxidation,maintain ATPaseactivity and keep the normal volume of erythrocytes. 3.When used in intraoperative blood salvage,edaravone can preserve thephysiological shape and function of red blood cells,resulting in less hemolysis.So it can increase the red blood cell recovery rate.It has certain protectiveeffect on red blood cells in salvaged blood.