A mathematical model of cell salvage compared and combined with normovolemic hemodilution

Transfusion
Jonathan H WatersMatthew T Karafa

Abstract

Mathematical models have been used to describe the factors that affect cell salvage (CS) and normovolemic hemodilution (ANH). Here, the CS and ANH models were used to compare these two techniques alone or in combination with each other. Variables used for a hypothetical patient included an estimated blood volume of 5000 mL, a presurgery hematocrit (Hct) of 45 percent, and a transfusion trigger of 21 percent. The model accounts for both the effect of decreasing the Hct due to blood loss and the effect of increasing Hct due to the readministration of blood in an isovolemic patient. The efficacy of CS and ANH is defined to be the maximum allowable blood loss for a fixed blood volume and a fixed transfusion trigger. Comparison of CS with ANH showed that 3 units of ANH was comparable to CS when CS recovery rates ranged from 19 to 24 percent. For a patient with a blood volume of 5000 mL and a starting Hct of 40 percent, 3 units of ANH would allow for 3972 mL of blood to be lost before crossing a 21-percent transfusion trigger, whereas CS with a 125-mL bowl would allow for 7611 mL. When comparing ANH to CS, this mathematical model would suggest that CS has the potential to offer significantly greater red blood cell avoidance than does...Continue Reading

References

Nov 1, 1987·Anaesthesia and Intensive Care·A K RonaiA S Shapiro
Feb 1, 1994·Transfusion·M E Brecher, M Rosenfeld
Jul 4, 2002·Journal of Vascular Surgery·Francesco TorellaCharles N McCollum
Oct 29, 2002·Anesthesia and Analgesia·Jonathan H WatersMatthew T Karafa

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Citations

Feb 22, 2007·Anesthesia and Analgesia·Jonathan H WatersMarina V Kameneva
Jun 2, 2010·Clinics in Laboratory Medicine·Jonathan H Waters
May 28, 2008·Journal of Cardiothoracic and Vascular Anesthesia·Paul G LoubserAryeh Shander
Mar 23, 2013·The Journal of Arthroplasty·Sharat K KusumaRay C Wasielewski
Jun 1, 2005·Anesthesiology Clinics of North America·Jonathan H Waters
Jul 22, 2011·The Journal of Bone and Joint Surgery. American Volume·Eva Y W TseKeith D K Luk
Mar 22, 2018·Anesthesiology·Grace LimHolger K Eltzschig
Nov 17, 2021·Spine Deformity·Nicholas D FletcherThomas M Austin

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