The Impact of Three Different Wash Solutions on Autotransfusion Products

Abstract

Many blood conservation techniques and strategies have been implemented to aid in decreasing the use of allogenic blood utilization during pediatric cardiothoracic surgery. Use of techniques, such as acute normovolemic hemodilution, retrograde autologous prime, venous autologous prime, and autotransfuion, may lead to a decrease in the need for allogenic blood products. Autotransfusion has become a standard of care for all cardiothoracic surgical procedures requiring cardiopulmonary bypass (CPB). Although widely used, there is still debate over which wash solution will produce the most physiologically normal autotransfusion product. Pediatric patients can be at a higher risk for electrolyte imbalance intraoperatively and postoperatively. In an attempt to minimize this, we sought out to evaluate three different wash solutions and how they would affect the final autotransfusion product. This comparison consisted of three wash solutions; .9% sodium chloride, Normosol-R^™, and Plasma-Lyte A. Based on the evaluation of all wash solutions, Plasma-Lyte A produced the most physiological normal final autotransfusion product in regards to electrolytes.

Keywords: autotransfusion product; blood loss; cardiopulmonary bypass; cell saver; electrolyte imbalance; pediatrics.

Figure 1.

Blood and wash solution were mixed in reservoir. Pre wash sample taken from sample port and sent for analysis. Wash cycle started per instructions for use, once wash cycle completed, one save final spin was completed. After mixing post wash sample in the reinfusion bag, post sample was drawn and sent for analysis.