Plasma rocuronium concentration in cell salvage blood following cardiac surgery: a case series

J Clin Monit Comput. 2022 Aug;36(4):1213-1217. doi: 10.1007/s10877-021-00755-4. Epub 2021 Sep 1.

Abstract

Purpose: The aim of the study was to evaluate the plasma rocuronium concentration in autologous blood transfusion obtained from the cell salvage (CS) system following cardiac surgery with cardiopulmonary bypass (CPB).

Methods: This prospective observational study was conducted in a university teaching hospital from July to November 2020. Patients undergoing general anesthesia for cardiac surgery with CPB were enrolled in the study. After separation from CPB, residual blood remaining in the extracorporeal system was collected as the control sample. The second sample (CS blood) was collected from the autologous blood transfusion obtained after completion of the CS system with Cell Saver® Elite®. Hematocrit values of both samples were also examined.

Results: Ten subjects (aged 57-86 years) were enrolled in this study. Plasma rocuronium concentrations (ng/ml) were significantly lower in the CS blood (94.0 ± 77.5) compared to the control (2950 ± 812.2) (p = 0.002). Hematocrit values (%) were significantly higher in the CS blood (75.2 ± 11.3) compared to the control (40.2 ± 10.2) (p = 0.002).

Conclusion: Autologous blood transfusion obtained from CS system following cardiac surgery with CPB, only retained a small amount of plasma rocuronium concentration, therefore, the risk of autologous blood transfusion contributing to clinically relevant residual neuromuscular blockade postoperatively should be considered to be low.

Trial registration: This trial was registered in the University Hospital Medical Information Network under registration number UMIN000040877 (registration date; June 24, 2020).

Keywords: Autologous blood transfusion; Cardiac surgery; Cardiopulmonary bypass; Cell salvage; Plasma rocuronium concentration; Rocuronium.

Publication types

  • Observational Study

MeSH terms

  • Blood Loss, Surgical
  • Blood Transfusion, Autologous
  • Cardiac Surgical Procedures*
  • Cardiopulmonary Bypass
  • Humans
  • Rocuronium

Substances

  • Rocuronium