Technique Article

In Vitro Evaluation of the Fresenius Kabi CATSmart Autotransfusion System

^* Division of Cardiovascular and Thoracic Surgery, Department of Perfusion Services, Duke University Hospital, Durham, North Carolina
^† Maine Cardiovascular Institute, Maine Medical Center, Portland, Maine
^‡ Fresenius Kabi, Lake Zurich, Illinois
^§ Division of Pediatric Anesthesiology, Department of Anesthesiology, Duke University Hospital, Durham, North Carolina

Address correspondence to: Edmund H. Jooste, MBChB, Division of Pediatric Anesthesiology, Department of Anesthesiology, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710. E-mail: edmund.jooste@duke.edu

Received: 24 June 2016
Accepted: 18 October 2016

Abstract

Use of autotransfusion systems to collect, wash, and concentrate shed blood during surgical procedures is a widely used method for reducing postoperative anemia and the need for blood transfusions. The aim of this study was to evaluate the CATSmart Continuous Autotransfusion System wash program performance with small (200 or 700 mL) and large volumes (1,000 mL) of shed blood and to determine non-inferiority of the CATSmart to the C.A.T.S^plus system. Human whole blood was collected in citrate phosphate dextrose, diluted, and divided into two aliquots to be processed as a pair using the C.A.T.S^plus and CATSmart systems with their corresponding wash programs: low-volume, high quality/smart, or emergency wash. Final packed red cell product was analyzed for red blood cell (RBC), white blood cell, and platelet counts; hemoglobin; hemolysis; RBC recovery rates; and elimination of albumin, total protein, and potassium. The mean hematocrit (HCT) after processing with CATSmart and C.A.T.S^plus systems were 59.63% and 57.71%, respectively. The calculated overall RBC recovery rates on the CATSmart and C.A.T.S^plus systems were 85.41% and 84.99%, respectively. Elimination of albumin (97.5%, 98.0%), total proteins (97.1%, 97.5%), and potassium (92.1%, 91.9%) were also calculated for the CATSmart and C.A.T.S^plus systems. The CATSmart and C.A.T.S^plus systems both provided a high-quality product in terms of HCT, protein elimination, and hemolysis rates across the range of tested shed blood volumes and all wash programs. The study was able to confirm the CATSmart is non-inferior to the C.A.T.S^plus system.