Cardiopulmonary bypass using thawed red blood cell concentrates--experimental and clinical research
Irisawa, A.
Nihon Kyobu Geka Gakkai 35(6): 846-864
1987
ISSN/ISBN: 0369-4739 PMID: 3655450 Document Number: 288884
We investigated experimentally and clinically usefulness of the extracorporeal circulation using thawed red blood cell concentrates, plasma protein fractions, poloxamer 188 (antihemolytic agent) and thawed platelet concentrates. The experimental results were followed. (1) Poloxamer 188 was recognized to reduce the serum free hemoglobin level in the extracorporeal circulation using thawed red blood cell concentrates. (2) Thromboelastograms could be measured in the group adding thawed platelet concentrates. In the clinical study, we primed the extracorporeal circuit with thawed red blood cell concentrates, plasma protein fractions and poloxamer 188 and added thawed platelet concentrates after the extracorporeal circulation (group A. N = 8). The following results were obtained. (1) The serum free hemoglobin level and hemolysis starting point of osmotic fragility test of erythrocytes with the coil planet centrifuge method were comparatively higher level (65.6 .+-. 18.5 mg/dl, 102.1 .+-. 4.2 mOsm.) immediately after operation than group B (cases using fresh whole blood, N = 8), although returned normal level after the first postoperative day. (2) Renal failures due to hemolysis were not seen in both groups. (3) In group A, PT (prothrombin time) and PTT (partial thromboplastin time) were comparatively elongated and hypofibrinogenemia was transiently observed. But, there were not significant differences about the bleeding time (Ivy method) and amounts of the postoperative blood loss between both groups. (4) The postoperative liver dysfunction was recognized in 3 cases in group B, but none in group A. We concluded that the extracorporeal circulation using thawed red blood cell concentrates, plasma protein fractions, poloxamer 188 and thawed platelet concentrates will be useful to minimize hemolysis and infection due to blood transfusions so that the smooth blood supply will be expected at time of the emergent operation using these substances.