Sodium citrate effectively used in shed mediastinal blood autotransfusion after cardiac surgery

Background We used sodium citrate as an alternative anticoagulation agent to heparin in the procedure of autologous blood transfusion with patients with postoperative haemorrhage after CPB. The aim of study was to evaluate the efficacy and safety of sodium citrate used in shed mediastinal blood auto...

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Veröffentlicht in:Perfusion 2024-09, Vol.39 (6), p.1106-1112
Hauptverfasser: Hao, Xinghai, Chen, Yueling, Wang, Liangshan, Jia, Ming, Lu, Yang
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creator Hao, Xinghai
Chen, Yueling
Wang, Liangshan
Jia, Ming
Lu, Yang
description Background We used sodium citrate as an alternative anticoagulation agent to heparin in the procedure of autologous blood transfusion with patients with postoperative haemorrhage after CPB. The aim of study was to evaluate the efficacy and safety of sodium citrate used in shed mediastinal blood autotransfusion after cardiac surgery. Methods Ninety-three patients were divided into two groups in this study. In the control group, 52 patients’ shed mediastinal blood was discarded. The reinfusion group consisted of 41 patients receiving a reinfusion of washed autologous red cells from shed mediastinal blood. Each 400 mL shed blood sample was anticoagulated by 140 mL of 1.6% diluted sodium citrate in the washing procedure using a blood recovery machine. Hemoglobin (Hb), hematocrit (Hct), and electrolyte concentrations in both the patients and shed mediastinal blood were measured before and after this procedure. Results The mean volume of autotransfused shed blood was 239.5 ± 54.6 mL.The Hct of the washed red cells was 56.8 ± 6.1%. Significantly, fewer units of allogeneic blood were required per patient in the reinfusion group at 24 h postoperatively (2.91 ± 1.34 vs 4.03 ± 0.19 U, p = 0.002). At 24 h postoperatively, Hb and Hct levels were higher in the reinfusion group than in the control group. The calcium ion concentration was very low in the shed mediastinal blood, 0.25 ± 0.08 mmol/L, and was lower after washing, 0.15 ± 0.04 mmol/L. Conclusions Sodium citrate, as an alternative anticoagulant agent, can be used in autologous shed mediastinal blood transfusion after CPB cardiac surgery. This procedure can effectively reduce the amount of allogeneic blood for patients with haemorrhage.
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The aim of study was to evaluate the efficacy and safety of sodium citrate used in shed mediastinal blood autotransfusion after cardiac surgery. Methods Ninety-three patients were divided into two groups in this study. In the control group, 52 patients’ shed mediastinal blood was discarded. The reinfusion group consisted of 41 patients receiving a reinfusion of washed autologous red cells from shed mediastinal blood. Each 400 mL shed blood sample was anticoagulated by 140 mL of 1.6% diluted sodium citrate in the washing procedure using a blood recovery machine. Hemoglobin (Hb), hematocrit (Hct), and electrolyte concentrations in both the patients and shed mediastinal blood were measured before and after this procedure. Results The mean volume of autotransfused shed blood was 239.5 ± 54.6 mL.The Hct of the washed red cells was 56.8 ± 6.1%. Significantly, fewer units of allogeneic blood were required per patient in the reinfusion group at 24 h postoperatively (2.91 ± 1.34 vs 4.03 ± 0.19 U, p = 0.002). At 24 h postoperatively, Hb and Hct levels were higher in the reinfusion group than in the control group. The calcium ion concentration was very low in the shed mediastinal blood, 0.25 ± 0.08 mmol/L, and was lower after washing, 0.15 ± 0.04 mmol/L. Conclusions Sodium citrate, as an alternative anticoagulant agent, can be used in autologous shed mediastinal blood transfusion after CPB cardiac surgery. This procedure can effectively reduce the amount of allogeneic blood for patients with haemorrhage.</description><identifier>ISSN: 0267-6591</identifier><identifier>ISSN: 1477-111X</identifier><identifier>EISSN: 1477-111X</identifier><identifier>DOI: 10.1177/02676591231171271</identifier><identifier>PMID: 37060259</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; Anticoagulants ; Anticoagulants - therapeutic use ; Autotransfusion ; Blood levels ; Blood transfusion ; Blood Transfusion, Autologous - methods ; Blood transfusions ; Calcium (blood) ; Calcium ions ; Cardiac Surgical Procedures - methods ; Citrates - pharmacology ; Citric acid ; Electrolytic cells ; Female ; Heart ; Heart surgery ; Hematocrit ; Hemoglobin ; Hemorrhage ; Heparin ; Humans ; Ion concentration ; Male ; Middle Aged ; Operative Blood Salvage - methods ; Postoperative Hemorrhage - blood ; Postoperative Hemorrhage - prevention &amp; control ; Postoperative Hemorrhage - therapy ; Sodium ; Sodium citrate ; Sodium Citrate - pharmacology ; Surgery ; Transfusion ; Washing</subject><ispartof>Perfusion, 2024-09, Vol.39 (6), p.1106-1112</ispartof><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c320t-3345224dcd1fdf6a5bc152a8ba2c794d355cdc08054aed1ef131a22dc335c4c03</cites><orcidid>0000-0002-3135-5125</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/02676591231171271$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/02676591231171271$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37060259$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hao, Xinghai</creatorcontrib><creatorcontrib>Chen, Yueling</creatorcontrib><creatorcontrib>Wang, Liangshan</creatorcontrib><creatorcontrib>Jia, Ming</creatorcontrib><creatorcontrib>Lu, Yang</creatorcontrib><title>Sodium citrate effectively used in shed mediastinal blood autotransfusion after cardiac surgery</title><title>Perfusion</title><addtitle>Perfusion</addtitle><description>Background We used sodium citrate as an alternative anticoagulation agent to heparin in the procedure of autologous blood transfusion with patients with postoperative haemorrhage after CPB. The aim of study was to evaluate the efficacy and safety of sodium citrate used in shed mediastinal blood autotransfusion after cardiac surgery. Methods Ninety-three patients were divided into two groups in this study. In the control group, 52 patients’ shed mediastinal blood was discarded. The reinfusion group consisted of 41 patients receiving a reinfusion of washed autologous red cells from shed mediastinal blood. Each 400 mL shed blood sample was anticoagulated by 140 mL of 1.6% diluted sodium citrate in the washing procedure using a blood recovery machine. Hemoglobin (Hb), hematocrit (Hct), and electrolyte concentrations in both the patients and shed mediastinal blood were measured before and after this procedure. Results The mean volume of autotransfused shed blood was 239.5 ± 54.6 mL.The Hct of the washed red cells was 56.8 ± 6.1%. Significantly, fewer units of allogeneic blood were required per patient in the reinfusion group at 24 h postoperatively (2.91 ± 1.34 vs 4.03 ± 0.19 U, p = 0.002). At 24 h postoperatively, Hb and Hct levels were higher in the reinfusion group than in the control group. The calcium ion concentration was very low in the shed mediastinal blood, 0.25 ± 0.08 mmol/L, and was lower after washing, 0.15 ± 0.04 mmol/L. Conclusions Sodium citrate, as an alternative anticoagulant agent, can be used in autologous shed mediastinal blood transfusion after CPB cardiac surgery. This procedure can effectively reduce the amount of allogeneic blood for patients with haemorrhage.</description><subject>Aged</subject><subject>Anticoagulants</subject><subject>Anticoagulants - therapeutic use</subject><subject>Autotransfusion</subject><subject>Blood levels</subject><subject>Blood transfusion</subject><subject>Blood Transfusion, Autologous - methods</subject><subject>Blood transfusions</subject><subject>Calcium (blood)</subject><subject>Calcium ions</subject><subject>Cardiac Surgical Procedures - methods</subject><subject>Citrates - pharmacology</subject><subject>Citric acid</subject><subject>Electrolytic cells</subject><subject>Female</subject><subject>Heart</subject><subject>Heart surgery</subject><subject>Hematocrit</subject><subject>Hemoglobin</subject><subject>Hemorrhage</subject><subject>Heparin</subject><subject>Humans</subject><subject>Ion concentration</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Operative Blood Salvage - methods</subject><subject>Postoperative Hemorrhage - blood</subject><subject>Postoperative Hemorrhage - prevention &amp; control</subject><subject>Postoperative Hemorrhage - therapy</subject><subject>Sodium</subject><subject>Sodium citrate</subject><subject>Sodium Citrate - pharmacology</subject><subject>Surgery</subject><subject>Transfusion</subject><subject>Washing</subject><issn>0267-6591</issn><issn>1477-111X</issn><issn>1477-111X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMtKAzEUhoMotlYfwI0E3LiZmpPLTLuU4g0EFyq4GzK51JTppCYToW9vSquC4uoQzvf_h3wInQIZA1TVJaFlVYopUJafQCvYQ0PgVVUAwOs-Gm72xQYYoKMYF4QQzjk7RANWkZJQMR2i-slrl5ZYuT7I3mBjrVG9-zDtGqdoNHYdjm95Lo12Mvauky1uWu81lqn3OdRFm6LzHZa2NwErGTKocExhbsL6GB1Y2UZzspsj9HJz_Ty7Kx4eb-9nVw-FYpT0BWNcUMq10mC1LaVoFAgqJ42kqppyzYRQWpEJEVwaDcYCA0mpVowJxRVhI3Sx7V0F_55M7Ouli8q0reyMT7GmEwLTCRWMZfT8F7rwKeR_xTp7JBQ4KWmmYEup4GMMxtar4JYyrGsg9cZ-_cd-zpztmlOTfX0nvnRnYLwFopybn7P_N34CXVCNJQ</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Hao, Xinghai</creator><creator>Chen, Yueling</creator><creator>Wang, Liangshan</creator><creator>Jia, Ming</creator><creator>Lu, Yang</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3135-5125</orcidid></search><sort><creationdate>20240901</creationdate><title>Sodium citrate effectively used in shed mediastinal blood autotransfusion after cardiac surgery</title><author>Hao, Xinghai ; Chen, Yueling ; Wang, Liangshan ; Jia, Ming ; Lu, Yang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c320t-3345224dcd1fdf6a5bc152a8ba2c794d355cdc08054aed1ef131a22dc335c4c03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Anticoagulants</topic><topic>Anticoagulants - therapeutic use</topic><topic>Autotransfusion</topic><topic>Blood levels</topic><topic>Blood transfusion</topic><topic>Blood Transfusion, Autologous - methods</topic><topic>Blood transfusions</topic><topic>Calcium (blood)</topic><topic>Calcium ions</topic><topic>Cardiac Surgical Procedures - methods</topic><topic>Citrates - pharmacology</topic><topic>Citric acid</topic><topic>Electrolytic cells</topic><topic>Female</topic><topic>Heart</topic><topic>Heart surgery</topic><topic>Hematocrit</topic><topic>Hemoglobin</topic><topic>Hemorrhage</topic><topic>Heparin</topic><topic>Humans</topic><topic>Ion concentration</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Operative Blood Salvage - methods</topic><topic>Postoperative Hemorrhage - blood</topic><topic>Postoperative Hemorrhage - prevention &amp; control</topic><topic>Postoperative Hemorrhage - therapy</topic><topic>Sodium</topic><topic>Sodium citrate</topic><topic>Sodium Citrate - pharmacology</topic><topic>Surgery</topic><topic>Transfusion</topic><topic>Washing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hao, Xinghai</creatorcontrib><creatorcontrib>Chen, Yueling</creatorcontrib><creatorcontrib>Wang, Liangshan</creatorcontrib><creatorcontrib>Jia, Ming</creatorcontrib><creatorcontrib>Lu, Yang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Perfusion</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hao, Xinghai</au><au>Chen, Yueling</au><au>Wang, Liangshan</au><au>Jia, Ming</au><au>Lu, Yang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sodium citrate effectively used in shed mediastinal blood autotransfusion after cardiac surgery</atitle><jtitle>Perfusion</jtitle><addtitle>Perfusion</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>39</volume><issue>6</issue><spage>1106</spage><epage>1112</epage><pages>1106-1112</pages><issn>0267-6591</issn><issn>1477-111X</issn><eissn>1477-111X</eissn><abstract>Background We used sodium citrate as an alternative anticoagulation agent to heparin in the procedure of autologous blood transfusion with patients with postoperative haemorrhage after CPB. The aim of study was to evaluate the efficacy and safety of sodium citrate used in shed mediastinal blood autotransfusion after cardiac surgery. Methods Ninety-three patients were divided into two groups in this study. In the control group, 52 patients’ shed mediastinal blood was discarded. The reinfusion group consisted of 41 patients receiving a reinfusion of washed autologous red cells from shed mediastinal blood. Each 400 mL shed blood sample was anticoagulated by 140 mL of 1.6% diluted sodium citrate in the washing procedure using a blood recovery machine. Hemoglobin (Hb), hematocrit (Hct), and electrolyte concentrations in both the patients and shed mediastinal blood were measured before and after this procedure. Results The mean volume of autotransfused shed blood was 239.5 ± 54.6 mL.The Hct of the washed red cells was 56.8 ± 6.1%. Significantly, fewer units of allogeneic blood were required per patient in the reinfusion group at 24 h postoperatively (2.91 ± 1.34 vs 4.03 ± 0.19 U, p = 0.002). At 24 h postoperatively, Hb and Hct levels were higher in the reinfusion group than in the control group. The calcium ion concentration was very low in the shed mediastinal blood, 0.25 ± 0.08 mmol/L, and was lower after washing, 0.15 ± 0.04 mmol/L. Conclusions Sodium citrate, as an alternative anticoagulant agent, can be used in autologous shed mediastinal blood transfusion after CPB cardiac surgery. This procedure can effectively reduce the amount of allogeneic blood for patients with haemorrhage.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>37060259</pmid><doi>10.1177/02676591231171271</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-3135-5125</orcidid></addata></record>
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subjects Aged
Anticoagulants
Anticoagulants - therapeutic use
Autotransfusion
Blood levels
Blood transfusion
Blood Transfusion, Autologous - methods
Blood transfusions
Calcium (blood)
Calcium ions
Cardiac Surgical Procedures - methods
Citrates - pharmacology
Citric acid
Electrolytic cells
Female
Heart
Heart surgery
Hematocrit
Hemoglobin
Hemorrhage
Heparin
Humans
Ion concentration
Male
Middle Aged
Operative Blood Salvage - methods
Postoperative Hemorrhage - blood
Postoperative Hemorrhage - prevention & control
Postoperative Hemorrhage - therapy
Sodium
Sodium citrate
Sodium Citrate - pharmacology
Surgery
Transfusion
Washing
title Sodium citrate effectively used in shed mediastinal blood autotransfusion after cardiac surgery
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