[Mechanical intraoperative autotransfusion].

Abstract

The cardiac effects during maximum pressure autotransfusion of blood which was anticoagulated by different methods, were studied in 2 series of 9 dogs. The animals, which were anaesthetized and splenectomized, received each 300 i.v. heparin/kg bodyweight intravenously before being subjected to repeated maximum pressure auto-transfusions of 10% of their whole blood volume. The anticoagulant employed during each autotransfusion was changed in station as follows: Heparin-(ACD-B)-Citrate-Heparin-CPD-Citrate... and so on. Criteria of cardiac efficiency, signs of insufficiency, pumpfunction (force of contraction, contractility) were all derived from the 4 phases of the aortic pressure tracing. In addition various parameters of the ECG, using the "Colletti distances", were measured. The results were proved by laboratory data. Immediately after the pre-determined bleeding (V) there was a characteristic fall of all parameters corresponding to the acute reduction in circulating blood volume, which returned to normal after the autotransfusion was completed (G). During the transitory phase S all data remained stable when heparin had been employed as the anticoagulant. Following the use of citrate, however, particularly CPD, there was an ensuing fall in all accounted for by the acute withdrawal of Ca++ which could be measured. Subsequently the circulation stabilized (ST) spontaneously and all parameters being measured returned to their original values when heparin and ACD-B had been used. With CPD, however, the force of contraction, enddiastolic pressures and propagation of electric activity of the heart were still altered.