Quality assessment of cell saved blood.

Pericardial blood during cardiac surgery is highly activated. This blood can be washed with a cell saver device. Unfortunately, fat and leukocyte particles are not adequately removed by cell savers. Fat and leukocytes could have a negative influence on blood coagulation. There are also concerns regarding coagulopathy after autotransfusion because of loss of plasma proteins, platelets and coagulation factors. In this study a reservoir will be used as a cell saver reservoir, because of it’s claimed filtration capacity of both leukocytes and lipids, and will be compared with a cell saver reservoir which does not remove leukocytes and lipids. The aim is to investigate the quality of this cell saver blood, and to see whether this affects also the coagulation profile of the patient after autotransfusion by performing thromboelastometry (ROTEM) and Calibrated Automated Thrombography (CAT).

We hypothesize that autotransfusion of leukocytes and lipid depleted cell saver blood leads to less prone inflammation and coagulopathy after cardiac surgery. We expect a less activated (cell derived-microparticle poor) and a more ‘pure’ (hemolysis free, leukocytes and lipid poor) autologous cell washed blood product.

T0: After induction of anaesthesia in operation room;

T1: Post cross-clamp in operation room;

T2: Post cardiopulmonary bypass in operation room;

T3: Post autotransfusion in the intensive care unit.

In total 50 patients will be assigned to the intervention group. In this group a autotransfusion reservoir which removes leukocytes and lipids will be used instead of the reservoir not removing leukocytes and lipids.