Abstract
The centrifugation and washing process of the autotransfuser removes plasma protein of blood from the surgical field. In order to promote recovery from hypoproteinemia after intraoperative salvaging autotransfusion, the salvaging of plasma protein collected in the waste bag of the autotransfuser was investigated in 11 patients undergoing cardiovascular surgery. Selective free-hemoglobin absorbent consisting of silica-gel beads was applied to remove large amounts of free-hemoglobin in the autotransfuser waste bag, a hemoconcentrator was used to remove saline, and a microfilter was placed in the circuit to remove platelet aggregates. The patients were divided into two groups: one column filled with the absorbent was used in 8 cases, two columns were used in 3 cases (one column could absorb approximately 10g of free-hemoglobin). In 6 cases in which the free-hemoglobin volume in waste was within the absorbing capacity of the column, most of the free-hemoglobin in waste was successfully absorbed and 70-90% of albumin or immunoglobulin could be saved with one column, but only 50% of albumin could be saved with two columns. Plasma protein in the waste bag of the autotransfuser might be saved by this method using free-hemoglobin absorbent, however, matching the volume of the absorbent to the shed blood volume was considered to be important to increase the recovery rate of plasma protein.
