Effects of unprocessed and processed cardiopulmonary bypass blood retransfused into patients after cardiac surgery

Background. The aim of this prospective study was to compare the effect of autologous unprocessed to processed residual cardiopulmonary bypass blood ( CPB) on patients' laboratory and clinical parameters and outcome. Methods. 20 patients undergoing elective coronary artery bypass surgery wer e randomized to receive either unprocessed CPB blood (control group) or pro cessed CPB blood employing the Continuous AutoTransfusion System (CATS; Fre senius, Bad Homburg, Germany). We have shown that this method eliminated >9 3% of activated mediators Serial laboratory parameters including complement activation, coagulation factors and the stimulation of IL-6 and IL-8 were compared with clinical side effects and patients' outcome. Results. Compared to control patients, retransfusion of unprocessed CBP blo od significantly increased heparin, free plasma hemoglobin and D-Dimers. Po stoperatively, three patients in the control group and two patients in the CATS group required prolonged mechanical ventilation or developed infection s associated respectively with elevated C3a (desArg) or IL-6 concentration. Conclusions. CATS-processing of CPB blood provided a high-qualify red blood cell concentrate, resulting in a reduced load of retransfused activated me diators.