Blood substitution and complement activation.

U Schött; O Berséus; P Järemo

doi:10.1111/j.1399-6576.1987.tb02621.x

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Blood substitution and complement activation.

U Schött·O Berséus·P Järemo

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Abstract

Complement activation was studied in 45 patients undergoing total hip arthroplasty under epidural anesthesia. The patients were randomly allocated to three groups. In Group I blood loss was replaced with microaggregate-poor erythrocyte concentrate (SAGM-ERC) plus 3% dextran-60 as plasma substitute, and postoperative analgesia was maintained with intramuscular ketobemidone. In Group II blood loss was replaced as in Group I, but epidural anesthesia was prolonged 12 h postoperatively and kept at a level of T4 with 0.5% bupivacaine. In Group III blood loss was replaced with non-frozen stored plasma plus SAGM-ERC, and postoperative analgesia was maintained with ketobemidone as in Group I. All groups received pre- and postoperative thrombo-prophylaxis with dextran. The plasma concentration of C3a-des-arginine (C3a-desArg) was measured by radioimmunoassay preoperatively, immediately after operation and 3, 6 and 18 h postoperatively. No significant differences in plasma C3 and C4 were found between the groups. C3a-desArg was significantly (P less than 0.01) increased up to 6 h postoperatively in Group III compared with both the preoperative value and Groups I and II. It is demonstrated that infusion of plasma can enhance or initiate endogenous complement activation. Blood component therapy with SAGM-ERC and 3% dextran-60, on the other hand, did not significantly increase the plasma level of C3a-desArg irrespective of the type of postoperative analgesia.

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Aged Anesthesia Blood Pressure Blood Substitutes Complement Activation Female Hemodynamics Hip Prosthesis Humans Male Middle Aged Clinical Trial Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

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U Schött, O Berséus, P Järemo. 1987. Blood substitution and complement activation.. https://doi.org/10.1111/j.1399-6576.1987.tb02621.x

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