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CARDIOVASCULAR ANESTHESIOLOGY

Intraoperative Autologous Transfusion of Hemolyzed Blood

Tod B. Sloan, MD, MBA, PhD^*, Greg Myers, MD^*, Daniel J. Janik, MD^*, Evalina M. Burger, MD, Vikas V. Patel, MD, and Leslie C. Jameson, MD^*

From the Departments of *Anesthesiology, and Orthopedics, University of Colorado Denver, Aurora, Colorado.

Address correspondence and reprint requests to Tod B. Sloan, MD, MBA, PhD, Department of Anesthesiology, University of Colorado at Denver and Health Sciences Center, Anschutz Office West (AO1), PO Box 6511, 12631 E 17th Ave., Aurora, CO 80045. Address e-mail to tod.sloan{at}ucdenver.edu.

Abstract

During two cases of lumbar spine surgery with instrumentation, we used intraoperative autologous transfusion (IAT), resulting in hemolysis during collection and hemoglobinuria and coagulation abnormalities after transfusion. Hemolysis during IAT collection can lead to hemoglobinuria and binding of nitric oxide, leading to vasoconstriction. The literature suggests that stroma from damaged cells and contact of the blood with the IAT device can lead to coagulation abnormalities and other morbidities, including adult respiratory distress syndrome.

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