Increased hemolysis in salvaged blood may indicate:
(1) a problem with the collection and processing system
(2) bacterial contamination
(3) other technical issue
The presence of increased hemolysis is associated with:
(1) red cell debris
(2) a potential potassium load
Hemolysis can be monitored by:
(1) plasma free hemoglobin in g/dL
(2) serum LDH in IU/L
(3) Hemolysis Index (available on automated chemistry instruments or with a spectrophotometer)
(4) serum potassium
The second, third and fouth methods show a linear correlation with plasma free hemoglobin.
In the data shown in Figures 1 and 2:
|
LDH in IU/L
|
plasma hemoglobin in g/dL =
|
|
69 to 485
|
= (0.0011884 * (LDH)) - 0.054222
|
|
> 485
|
= (0.0010523 * (LDH))
|
Limitations:
• Due to variation in the methods to measure serum LDH these equations would need to be adjusted for local analyzers.
• These markers assume that there is no other process going on such as liver disease, hemolytic transfusion reaction, etc.
