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Effects of intraoperative cell salvage on erythrocyte 2,3-disphosphoglycerate and free hemoglobin level in patients undergoing elective cardiac surgery

LI Xiuliang;DONG Peng;ZHANG Ye;TIAN Ming;Department of Anaesthesiology,Beijing Friendship Hospital,Capital Medical University;  
Objective To assess the effect of intraoperative cell salvage on 2,3-disphosphoglycerate( 2,3-DPG) and free hemoglobin( f Hb) level of red blood cells( RBCs) during elective cardiac surgery. Methods Fifteen patients scheduled for elective cardiac surgery were enrolled in this study. One auto-transfusion device was used to process the collected blood salvaged during the operation. The level of f Hb and 2,3-DPG from venous RBCs,salvaged RBCs and 2-week-old stored RBCs were measured. The changes of the above indexes of RBCs stored at 21-24 ℃ for 4 h and at 1-6 ℃ for 24 h were further measured. Results The 2,3-DPG level( μmol / g Hb) of venous RBCs,salvaged RBCs at 0 h,4 h and 24 h,as well as2-week-old stored RBCs was 12. 73±6. 52,17. 94±6. 91,15. 17±11. 61,15. 38± 5. 85 and 2. 62± 3. 1,respectively. The 2,3-DPG level of 0 h salvaged RBCs was significantly higher than that of venous RBCs( P 0. 01),and that of 2-week-old stored RBCs( P0. 01),while there was no statistically significant difference compared with the 2,3-DPG level of 4 h salvaged RBCs( P 0. 05) and the 2,3-DPG level of 24 h salvaged RBCs( P 0. 05). The percentage of hemolysis( %) of venous RBCs,salvaged RBCs at 0 h,4 h and 24 h,and 2-week-old stored RBCs was 0. 07±0. 05,0. 51±0. 27,1. 11±0. 42,1. 75±0. 69 and 0. 07±0. 05,respectively. The percentage of hemolysis of 0h salvaged RBCs was significantly higher than that of venous RBCs( P0. 01),and that of 2-week-old stored RBCs( P0. 01),and also it was significantly lower than that of4 h salvaged RBCs( P0. 01) and that of 24 h salvaged RBCs( P0. 01). Conclusion The salvaged RBCs during elective cardiac surgery was slightly destroyed,but had a better oxygen-carrying capacity.
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