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

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.