Complement activation and increased systemic and pulmonary vascular resistance indices during infusion of postoperatively drained untreated blood |
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Authors: | Krohn C D; Reikeras O; Mollnes T E |
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Institution: | National Hospital, Centre for Orthopaedics, Trondhjemsveien 132, N-0570 Oslo, Norway; University of Tromso, Department of Immunology and Transfusion Medicine, Nordland Central Hospital, N-8017 Bodo SSH, Norway |
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Abstract: | In nine healthy young patients, operated on for thoracic scoliosis, a
pulmonary artery catheter was inserted for the study of haemodynamic
variables and blood sampling during autologous transfusion of
postoperatively drained blood. At 1-3 h after wound closure, 10 ml kg/body
weight of drained untreated blood from the wound was collected and
recirculated over a l-h period. The concentration of the complement
activation product, C3bc, increased from a mean of 5.4 (SD 1.5) AU ml-1
before infusion to 11.1 (3.9) AU ml-1 during infusion and then returned to
7.8 (2.8) AU ml-1 after infusion. The concentration of the terminal
complement complex (TCC) increased from 0.5 (0.2) to 1.3 (0.5) AU ml-1 and
was reduced to 0.7 (0.3) AU ml-1 after infusion. Only TCC exceeded the
reference values which are 14 AU ml-1 for C3bc and 1.0 AU ml-1 for TCC.
Pulmonary vascular resistance index concomitantly increased from a mean of
130 (SD 52) to 195 (88) dyn s cm-5 m-2 and was reduced to 170 (86) dyn s
cm-5 m-2 after infusion. Systemic vascular resistance index increased from
a mean of 1238 (SD 403) to 1349 (473) dyn s cm-5 m-2 and returned to 1196
(401) dyn s cm-5 m-2 after infusion. White blood cell count (WCC) increased
from 14.4 (4.3) x 10(9) litre-1 before infusion to 17.8 (7.2) x 10(9)
litre-1 during and after infusion. No change in platelet count during
infusion was observed. There were no differences in WCC or platelet count
between mixed venous or peripheral arterial blood. Pulmonary and systemic
vascular resistance indices may be influenced by activated complement in
drained untreated blood when it is recirculated.
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