Korean J Hematol.  2011 Mar;46(1):31-35. 10.5045/kjh.2011.46.1.31.

The impact of suctioning RBCs from a simulated operative site on mechanical fragility and hemolysis

• Raval JS
• Waters JH
• Yazer MH

• KMID: 2252016
• DOI: http://doi.org/10.5045/kjh.2011.46.1.31

Abstract

BACKGROUND
Intraoperative cell salvage exerts shear stress upon RBCs, particularly as they are suctioned from the surgical field. Shear stress can result in overt hemolysis or it can cause sublethal injury to the suctioned RBCs. The mechanical fragility (MF) test uses shear stress to measure the extent of RBC sublethal injury. RBCs that have sustained sublethal injury are more susceptible to shear stress induced hemolysis. In this study we suctioned whole blood samples from an artificial surgical field to determine if pre-menopausal female RBCs would demonstrate greater resistance to hemolysis and less sublethal injury compared to that of males and post-menopausal females.
METHODS
Ten CPD-preserved whole blood units from these 3 donor groups were obtained and samples suctioned at -150 mmHg from a simulated surgical field. The MF test was then performed and the % hemolysis calculated. In addition the MF test was serially performed on these whole blood units during the 21 days of storage.
RESULTS
There were no differences in the extent of hemolysis or RBC shear stress resistance after suctioning between the 3 donor groups. During storage the pre-menopausal female RBCs demonstrated higher shear stress tolerance compared to the males or post-menopausal females at all of the time points.
CONCLUSION
Although during static storage pre-menopausal female RBCs in CPD-preserved whole blood demonstrated higher shear stress tolerance, this enhanced resistance was not observed after suctioning from a simulated surgical field.

Keyword

Red blood cell; Mechanical fragility; Suctioning; Cell salvage; Hemolysis; Storage lesion; Peri-operative

MeSH Terms

Erythrocytes
Female
Hemolysis
Humans
Male
Suction
Tissue Donors

Figure

• 

  Fig. 1 The mean MFI of RBCs in CPD-preserved whole blood from each donor group before and after suctioning. Ten whole blood units from each of these 3 donor demographics were tested. For all 3 donor groups there was no statistically significant change in the MFI after suctioning. The pre-menopausal female RBCs demonstrated lower pre-suctioning MFI values compared to the post-menopausal female RBCs (P<0.01) and the male RBCs (P<0.001). Likewise, the pre-menopausal female RBCs demonstrated lower post-suctioning MFI values compared to the post-menopausal female RBCs (P<0.05) and the male RBCs (P<0.001). The error bars represent 1 SD.

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  Fig. 2 The mean % hemolysis of RBCs in CPD-preserved whole blood from each donor group before and after suctioning. Ten whole blood units from each of these 3 donor demographics were tested. For all 3 donors groups there was a statistically significant increase in the % hemolysis after suctioning. The pre-suction % hemolysis values did not differ significantly between the 3 groups. Likewise the post-suction % hemolysis values did not differ significantly between the 3 groups. The error bars represent 1 SD.

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  Fig. 3 The mean MFI of RBCs in CPD-preserved whole blood from the 3 donor groups measured serially over 21-days of storage. Ten whole blood units from each of these 3 donor demographics were tested. The MFI of the pre-menopausal females was significantly lower than that of both the males at all of the time points (P<0.001) and post-menopausal females (P<0.01 at days 3 and 7, P<0.001 at days 14 and 21).

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  Fig. 4 The mean % hemolysis in CPD-preserved whole blood units from the 3 donor groups measured serially over 21-days of storage. Ten whole blood units from each of these 3 donor demographics were tested. The increase in % hemolysis over time was not significant for any of the 3 donor groups, nor was the difference in the % hemolysis at any of the time points significantly different between the 3 donor groups.

Reference

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