Removal of lepirudin used as an anticoagulant in mechanical autotransfusion with Cell-Saver 5

Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
A MarxE Lindhoff-Last

Abstract

Former studies demonstrated that small amounts of heparin might remain in the prepared retransfusion blood during intraoperative autotransfusion. This could lead to serious complications in patients suffering from heparin-induced-thrombocytopenia type II (HIT II). Lepirudin is an approved anticoagulant in HIT II-patients. We studied to what extent lepirudin is washed out during the preparation of retransfusion blood, when it is used as anticoagulant for the autotransfusion device cell saver 5. We investigated four different concentrations of lepirudin solutions, 5 mg, 10 mg, 20 mg and 30 mg per litre normal saline. In order to imitate a clinical situation, each lepirudin solution was mixed with human blood in a 1:5-ratio and put into the reservoir of the cell saver. The device was started in the automatic mode using 1000 ml saline as washing solution. Several runs were carried out (five times using the 5 mg/l solution, ten times the 10 mg/l, eleven times the 20 mg/l and eleven times the 30 mg/l solution). The lepirudin concentration in the prepared retransfusion blood was measured. The median percentage reduction of the lepirudin content from the reservoir blood to the retransfusion blood was 100% for the 5 mg/l, 90.4% for the ...Continue Reading

Citations

Jul 16, 2016·BMC Anesthesiology·Martin BeiderlindenTanja A Treschan
Jul 19, 2008·Interactive Cardiovascular and Thoracic Surgery·Konstantin S NaumenkoSergey E Naumenko

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