The Influence Of Washing Autotransfusion With Different Washing Liquid On Coagulation Function, PH And Electrolyte

Objective In order to check the difference between two washing solution, so that reduce the impact on body raised in the process of washed red blood; to avoid delaying rescue oPPortunity because of the time for cross-matching of blood on condition that reduce the volatility of pHysiological indices in Patients. To reduce Patients'risks for allogeneic blood transfusion, to reduce the high cost of medical exPenses with banked blood while saving Precious blood resources for the community. to assess the risks better in clinical work, to observe the changes in Patients' condition more carefully, to adoPt Practical measures that can reduce comPlications。Methods According to the sub-clinical trials, the 60 Patients in the line with the standard were seParated into two grouPs randomly. GrouP A: Collect the red blood cell and wash with Normal Saline. Detect the Patients' RBC,Hb,Hct,PLT,PT,APTT,ACT,pH,K+,Na+,Cl-,Ca2+ PreoPeratives,before autotransfusion and autotransfusion 60 min later. Detect the pH,K+,Na+,Cl-,Ca2+ of the washed red blood cells. GrouP B: use the Ringer's solution substitutions Normal Saline, rePeat the above Process. All the data were analyzed by SPSS 13.0.Statistical method was: x±s and rePeated measure analysis of variance.Results 1.Both in GrouP A and GrouP B:the RBC, Hb and Hct before autotransfusion was much lower than that PreoPerative (P<0.05); and after autotransfusion was much higher than that before autotransfusion (P< 0.05); all indicators after autotransfusion were lower than that PreoPerative (P<0.05). However, there was no statistical significance between GrouP A and B (P>0.05).2.A, B grouPs before surgery, before and after autotransfusion, there was no significant difference on PT, APTT, ACT(P>0.05). PLT before and afer autotransfusion were both lower than that PreoPerative(P<0.05), there was no statistical significance between the PLT before and afer autotransfusion (P>0.05).And there was no statistical significance between GrouP A and B (P＞0.05)3.There was no statistical significance on pH and electrolyte PreoPerative and before autotransfusion (P>0.05). In both grouPs, pH after autotransfusion was lower than PreoPerative and before autotransfusion (P <0.05), but still in normal range.The changes of electrolyte:In both grouPs, comPared to that before autotransfusion and PreoPerative, Cl- after autotransfusion was higher (P< 0.05),but still in normal range; there was no statistical significance on K+,Na+,Ca2+(P>0.05).ComPare indicators PreoPerative with those after autotransfusion, there was no statistical significance.4. Washed red blood cell:both in GrouP A and B, comPared with body functional level, pH was lower than normal value (P<0.05); Na+,Cl-were higher than normal level (P<0.05), and the Na+ rise in GrouP A was more obvious (P<0.05); K+,Ca2+ in GrouP A were lower than normal level (P＜0.05), in GrouP B was in normal tolerance; there was statistical significance between GrouP A and B (P<0.05).5. In 24 hours after autotransfusion, there was 2066±584ml Urine for the 30 Patients in GrouP A, and 2200±495 ml in GrouP B. There was no statistical significance between two grouPs (P>0.05). And there was no Hemoglobinuria in any of the 60 Patients.6. In the 24 hours after oPeration, Drainage was 669±267 ml in grouP A, and 656±287 ml in GrouP B. There was no statistical significance between two grouPs (P>0.05).7. In this experiment,57000ml RBC has been collected, the most is 1600 ml, and the least is 600 ml. Totally saved banked blood 285U by the 60 Patients.Conclusions1. Washing autotransfusion is a safe and effective treatment, it can effectively imProve the anemia that suffered from Surgical blood loss, can reduce the risk from Allogeneic blood transfusion, meanwhile reduce the health care costs and save Precious blood resources for the community.2.Washing autotransfusion does not imPact coagulation function significantly, the results washed by Normal saline and Ringer's are the same. ZT-3000 Blood Collector can clear heParin completely without bad imPact.3. After washed by normal saline and Ringer, Na+,Cl- of red blood cell increase, pH decrease, and the changes of Na+ is more obvious in normal saline. K+,Ga2+ in red blood cell washed by normal saline will decrease, while Ringer can imProve this issue.Washing autotransfusion with Normal saline and Ringer can decrease the pH and slightly increase Cl" after autotransfusion which is still within the normal tolerance, but it doesn't means there is no Possibility of acidosis with high Cl" when a large number of washing autotransfusion adoPted. More attention should be Paid in clinical aPPlication. Washing autotransfusion did not imPact K+,Na+,Ga2+ obviously.