Maria Tylman

Complement split products and pro-inflammatory cytokines in salvaged blood after hip and knee arthroplasty.

Purpose: To determine whether salvaged autologous blood collected postoperatively contains complement split products (SC5b-9), and pro-inflammatory cytokines (IL-6 and IL-8) and whether there are any differences between blood collected during hip or knee surgery.Methods: Fifty-eight consecutive patients undergoing hip or knee replacement surgery were studied. Thirty-eight had postoperative bleeding large enough to require infusion of salvaged blood. The salvaged blood was filtered during collection through a 200 µm filter and before infusion a 40 µm filter was used. Samples for complement and cytokine determinations were drawn from the circulation and from the collected blood.Results: High concentrations of SC5b-9, IL-6, and IL-8 were found in salvaged blood. The concentrations were higher than in the circulation (P<0.05). The circulating concentrations of IL-6 and IL-8 were increased 60 min and 12–18 hr after transfusion. There were no differences regarding SC5B-9, IL-6, and IL-8 in the blood collected after hip or knee surgery.Conclusion: Blood collected from a surgical wound contains large concentrations of inflammatory mediators. There were no differences between blood collected during hip or knee surgery.RésuméObjectif: Déterminer si la récupération postopératoire de sang autologue contient des produits de dégradation du complément (SC 5b-9) et des cytokines pro-inflammatoires (IL-6 et IL-8), et s’il y a des différences avec le sang prélevé pendant l’opération de la hanche ou du genou.Méthode: L’étude a porté sur 58 patients successivement admis pour la mise en place d’une prothèse de hanche ou du genou. Chez 38 d’entre eux, les pertes sanguines postopératoires ont été assez importantes pour nécessiter la transfusion de sang récupéré. Ce sang a été filtré pendant le prélèvement avec un filtre de 200 µm et avant la transfusion avec un filtre de 40 µm. Des échantillons retenus de la circulation et du sang récupéré ont servi à déterminer la cytokine et le complément.Résultats: De fortes concentrations de SC5B-9, IL-6 et IL-8 ont été trouvées dans le sang récupéré. Elles étaient plus élevées que celles de la circulation (P<0,05). Les concentrations circulantes de IL-6 et de IL-8 ont augmenté 60 min et 12–18 h après la transfusion. Aucune différence n’a été enregistrée concernant les SC5b-9, IL-6 et IL-8 dans le sang prélevé après l’opération de hanche ou du genou.Conclusion: Le sang prélevé au site d’incision chirurgicale contient de grandes concentrations de médiateurs de l’inflammation. Ce sang ne présente pas de différence avec celui qui est prélevé pendant une opération de hanche ou du genou.

Plasma concentration of procalcitonin and systemic inflammatory response syndrome after colorectal surgery.

Background:  To study whether plasma concentrations of procalcitonin (PCT), interleukin‐6 (IL‐6), complement 3a (C3a), C‐reactive protein and white blood cell count (WBC) correlate with the presence of systemic inflammatory response syndrome (SIRS) during the early post‐operative period after major colorectal surgery.

Activation of the complement system by different autologous transfusion devices : an in vitro study

BACKGROUND : The aim of the present investigation was to study whether autologous transfusion devices activate the complement system and whether complement‐activated blood is more vulnerable to further activation during processing.

Complement split products and proinflammatory cytokines in intraoperatively salvaged unwashed blood during hip replacement: comparison between heparin-coated and non-heparin-coated autotransfusion systems.

Background and Objectives  The aim of the present study was to investigate the quality of shed blood collected in a new intraoperative autotransfusion system (Sangvia®, AstraTech, Sweden) and to study whether heparin‐coated surfaces in the device reduce the production of inflammatory mediators.