Analysis of Red Blood Cell Aggregation in Cardio-Pulmonary Bypass (CPB) Surgery

Abstract

Not much is known about red cell aggregation during cardio-pulmonary bypass surgery (CPB). Blood samples from 19 patients undergoing CPB were anticoagulated with EDTA. Hematocrit was adjusted to 40%. A red blood cell aggregometer (LORCA) measured changes in light reflection from each blood sample after cessation of the rotation, and calculated an aggregation index (AI). Reflection measurements were stored. Because LORCA software failed for 87 of 171 samples, we developed new software, and applied it to the stored reflection measurements. This software failed only in 7 out of 171 cases and showed that all LORCA failures occurred for AI < 40%. The new calculations revealed that the aggregation index significantly decreased from 46.6 ± 10.1 (mean ± standard deviation) baseline to 22.8 ± 8.3 at the end of CPB and recovered to 37.1 ± 13.5 at day 1. It is concluded that the new software can be used to study decreased red cell aggregation during CPB.

Keywords

Red blood cell aggregation Cardiopulmonary bypass Algorithms

Get full access to this article

View all access options for this article.

References

Lohrer

R.M.

, Trammer

A.R.

, Dietrich

, Hagl

, Linderkamp

. The influence of extracorporeal circulation and hemo-separation on red cell deformability and membrane proteins in coronary artery disease. J Thorac Cardiovasc Surg 1990; 99: 735–40.

Kameneva

M.V.

, Undar

, Antaki

J.F.

, Watach

M.J.

, Calhoon

J.H.

, Borovetz

H.S.

. Decrease in red blood cell deformability caused by hypothermia, hemodilution, and mechanical stress: factors related to cardiopulmonary bypass. ASAIO J 1999; 45: 307–10.

Chabanel

, Samama

. Evaluation of a method to assess red blood cell aggregation. Biorheology 1989; 26: 785–97.

Graaff

, Aarnoudse

J.G.

, Zijp

J.R.

, Sloot

P.M.A.

, de Mul

FFM

, Greve

, Koelink

M.H.

. Reduced light-scattering properties for mixtures of spherical particles: A simple approximation derived from Mie calculations. Appl Opt 1992; 31: 1370–76.

Graaff

, Dassel

A.C.M.

, Koelink

M.H.

, de Mul

FFM

, Aarnoudse

J.G.

, Zijlstra

W.G.

. Optical properties of human dermis in vitro and in vivo. Appl Opt 1993; 32: 435–47.

Jansonius

N.J.

. Quantitative studies on rouleaux formation of erythrocytes by reflection measurement (syllectometry). Dissertation, University of Groningen, The Netherlands. Groningen: Van Denderen, 1959.

Zijlstra

W.G.

, Mook

G.A.

. Quantitative evaluation of the rate of rouleaux formation of erythrocytes. Syllectometry. In: Medical reflection photometry. Assen, The Netherlands: Van Gorcum, 1962; pp. 250–70.

Jansonius

N.J.

, Zijlstra

W.G.

. Various factors influencing rouleaux formation of erythrocytes, studied with the aid of syllectometry. Kon Ned Acad Wet C 1965; 68: 121–7.

Schmid-Schönbein

, Volger

, Klose

H.J.

. Microrheology and light transmission of blood. Pflügers Arch 1972; 333: 140–55.

10.

Schmid-Schönbein

, Volger

, Teitel

, Kiesewetter

, Dauer

, Heilmann

. New hemorheological techniques for the routine laboratory. Clin Hemorheol 1982; 2: 93–105.

11.

Hardeman

M.R.

, Dobbe

J.G.G.

, Ince

. The laser-assisted optical rotational cell analyser (LORCA) as red blood cell aggregometer. Clin Hemorheol Microcirc 2001; 25: 1–11.

12.

Hardeman

M.R.

, Goedhart

P.T.

, Dobbe

J.G.G.

, Lettinga

K.P.

. Laser-assist optical rotational cell analyser (LORCA): I A new instrument for measurement of various hemorheological structural parameters. Clin Hemorheol 1994; 14: 605–18.

13.

Dobbe

J.G.G.

, Streeksta

G.J.

, Strackee

, Rutten

M.C.M.

, Stijnen

J.M.A.

, Grimbergen

C.A.

. Syllectometry: The effect of aggregometer geometry in the assessment of red blood cell shape recovery and aggregation. IEEE Trans Biomed Eng 2003; 50: 97–106.

14.

Morariu

A.M.

, van der Plaats

, van Oeveren

. Hyperaggregating effect of hydroxyethyl starch components and University of Wisconsin solution on human red blood cells: A risk of impaired graft perfusion in organ procurement? Transplantation 2003; 76: 37–43.