Suction-induced hemolysis at various vacuum pressures: implications for intraoperative blood salvage

Transfusion
S Gregoretti

Abstract

Suction vacuum pressure (VP) not exceeding 150 torr is recommended during intraoperative blood salvage to minimize hemolysis. When the suction provided by this VP becomes inadequate because of brisk bleeding, an alternative high-VP suction should be used and the blood discarded. This approach often results in the salvage of only a small fraction of the blood shed during surgery complicated by large hemorrhage. This laboratory study was designed to quantitate the hemolysis caused by various VPs in a suction system commonly used for intraoperative blood salvage. For each experiment, a batch of blood with a hematocrit of 30 to 35 percent was prepared by mixing of outdated units of red cells, fresh-frozen plasma, and saline solution. Aliquots of this blood were suctioned at VPs of 150, 200, 250, and 300 torr, either without (6 experiments) or with (4 experiments) maximal air entrainment. Total hemoglobin, hematocrit, red cell count, plasma-free hemoglobin, and serum potassium were measured in the blood before suction and in each aliquot after suction. Suction of blood mixed with air caused much greater hemolysis than suction of blood alone (p < 0.01 at each VP tested). Raising the VP from 150 to 300 torr increased hemolysis from 0....Continue Reading

Citations

Jun 1, 2005·Anesthesiology Clinics of North America·Jonathan H Waters
Mar 24, 2005·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Ralf Karger, Volker Kretschmer
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Apr 18, 2009·Anesthesia and Analgesia·Jonathan H Waters
Jun 20, 2014·International Anesthesiology Clinics·Jonathan H Waters
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