The effect of a novel turbulence-controlled suction system in the prevention of hemolysis and platelet dysfunction in autologous surgery blood

Background: Re-transfusion of autologous blood is an important aspect of intraoperative blood management. Hemolysis and platelet dysfunction due to turbulence in the blood suction system strongly impede later usage of suction blood for re-transfusion. The aim of this study was to analyze the effects...

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Bibliographic Details
Published in:Perfusion 2019-01, Vol.34 (1), p.58-66
Main Authors: Budde, Holger, Riggert, Joachim, Vormfelde, Steffen, Tirilomis, Theodor, Friedrich, Martin G.
Format: Article
Language:English
Subjects:
Adenosine diphosphate
Automatic control
Blood
Blood flow
Blood platelets
Blood transfusion
Control systems
Erythrocytes
Fluid dynamics
Glycoproteins
Hemoglobin
Hemolysis
Integrity
P-selectin
Platelets
Suction
Surgery
Transfusion
Turbulence
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Summary:Background: Re-transfusion of autologous blood is an important aspect of intraoperative blood management. Hemolysis and platelet dysfunction due to turbulence in the blood suction system strongly impede later usage of suction blood for re-transfusion. The aim of this study was to analyze the effects of a novel surgical-blood suction system with an automatic control setup for minimization of turbulence in the blood flow. Methods: We compared the turbulence-controlled suction system (TCSS) with a conventional suction system and untreated control blood in vitro. Blood cell counts, hemolysis levels according to free hemoglobin (fHb) and platelet function were analyzed to determine the integrity of the suction blood. Results: In the conventional suction system, we found a strong increase of the fHb levels. In contrast, erythrocyte integrity was almost completely preserved when using the TCSS. We obtained similar results regarding platelet function. The expression of platelet glycoproteins, such as GP IIb/IIIa and P-selectin, native or after stimulation with ADP, were markedly impaired by the conventional system, but not by the TCSS. In addition, platelet aggregometry revealed significant platelet dysfunction in conventional suction blood, but less aggregation impairments were present in blood samples from the TCSS. Conclusion: Our findings on an in vitro assessment show major improvements in red blood cell integrity and platelet function of suction blood when using the TCSS compared to a conventional suction system. These results reflect a significant benefit for autologous re-transfusion. We suggest testing the TCSS in surgery for clinical evaluation.
ISSN:0267-6591
1477-111X
DOI:10.1177/0267659118790915