Haematological alterations in the cardiac patient after use of an autotransfusion system | Revista Española de Anestesiología y Reanimación (English Edition)

array:24 ["pii" => "S2341192917302044" "issn" => "23411929" "doi" => "10.1016/j.redare.2017.12.004" "estado" => "S300" "fechaPublicacion" => "2018-02-01" "aid" => "862" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "copyrightAnyo" => "2017" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2018;65:74-80" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1 "PDF" => 1 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0034935617302116" "issn" => "00349356" "doi" => "10.1016/j.redar.2017.09.003" "estado" => "S300" "fechaPublicacion" => "2018-02-01" "aid" => "862" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Anestesiol Reanim. 2018;65:74-80" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 100 "formatos" => array:2 [ "HTML" => 84 "PDF" => 16 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original" "titulo" => "Alteraciones hematológicas en el paciente cardíaco tras uso de un sistema de autotransfusión" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "74" "paginaFinal" => "80" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Haematological alterations in the cardiac patient after use of an autotransfusion system" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1881 "Ancho" => 2833 "Tamanyo" => 215806 ] ] "descripcion" => array:1 [ "es" => "Diagrama de flujo." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Luque-Oliveros" "autores" => array:1 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Luque-Oliveros" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341192917302044" "doi" => "10.1016/j.redare.2017.12.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192917302044?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935617302116?idApp=UINPBA00004N" "url" => "/00349356/0000006500000002/v1_201801100532/S0034935617302116/v1_201801100532/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2341192917302111" "issn" => "23411929" "doi" => "10.1016/j.redare.2017.12.008" "estado" => "S300" "fechaPublicacion" => "2018-02-01" "aid" => "867" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2018;65:81-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "formatos" => array:2 [ "HTML" => 1 "PDF" => 1 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Diaphragmatic thickness ratio (inspiratory/expiratory) as a diagnostic method of diaphragmatic palsy associated with interscalene block" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "81" "paginaFinal" => "89" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La ratio de grosor diafragmático (inspiratorio/espiratorio) como método diagnóstico de parálisis diafragmática asociada al bloqueo interescálenico" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1470 "Ancho" => 1589 "Tamanyo" => 65987 ] ] "descripcion" => array:1 [ "en" => "Reduction of spirometric parameters observed at 20min after interscalene blockade, with respect to baseline levels." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V.M. López Escárraga, K. Dubos España, R.H. Castillo Bustos, L. Peidró, S. Sastre, X. Sala-Blanch" "autores" => array:6 [ 0 => array:2 [ "nombre" => "V.M." "apellidos" => "López Escárraga" ] 1 => array:2 [ "nombre" => "K." "apellidos" => "Dubos España" ] 2 => array:2 [ "nombre" => "R.H." "apellidos" => "Castillo Bustos" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Peidró" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Sastre" ] 5 => array:2 [ "nombre" => "X." "apellidos" => "Sala-Blanch" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935617302165" "doi" => "10.1016/j.redar.2017.09.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935617302165?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192917302111?idApp=UINPBA00004N" "url" => "/23411929/0000006500000002/v1_201802090832/S2341192917302111/v1_201802090832/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341192917302147" "issn" => "23411929" "doi" => "10.1016/j.redare.2017.11.015" "estado" => "S300" "fechaPublicacion" => "2018-02-01" "aid" => "877" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2018;65:69-73" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Editorial article" "titulo" => "Non-invasive multi-parametric cardiorespiratory assessment of the hemodynamically unstable patient" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "69" "paginaFinal" => "73" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Valoración cardiorrespiratoria no invasiva y multiparamétrica del paciente hemodinámicamente inestable" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Perel" "autores" => array:1 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Perel" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S003493561730244X" "doi" => "10.1016/j.redar.2017.11.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S003493561730244X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192917302147?idApp=UINPBA00004N" "url" => "/23411929/0000006500000002/v1_201802090832/S2341192917302147/v1_201802090832/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Haematological alterations in the cardiac patient after use of an autotransfusion system" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "74" "paginaFinal" => "80" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "M. Luque-Oliveros" "autores" => array:1 [ 0 => array:3 [ "nombre" => "M." "apellidos" => "Luque-Oliveros" "email" => array:1 [ 0 => "mluque5@us.es" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Bloque Quirúrgico y Anestesia Reanimación, Hospital Universitario Virgen Macarena, Sevilla, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Alteraciones hematológicas en el paciente cardíaco tras uso de un sistema de autotransfusión" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1881 "Ancho" => 2833 "Tamanyo" => 198084 ] ] "descripcion" => array:1 [ "en" => "Flowchart." ] ] ] "textoCompleto" => "IntroductionThe American Heart Association,<a class="elsevierStyleCrossRef" href="#bib0160">1</a> the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists<a class="elsevierStyleCrossRef" href="#bib0165">2</a> have described the cell saver (CS) autotransfusion system as an alternative to blood transfusion in cardiac surgery. The CS is an electronic device that salvages intraoperative blood loss and processes it for reinfusion. The process consists of separating and washing the red blood cells with physiological saline before reinfusion. The remaining contents, namely, plasma, platelets, clotting factors and products from the surgical site, are discarded.<a class="elsevierStyleCrossRef" href="#bib0170">3</a> Several studies have highlighted the safety, efficacy and efficiency of the CS.<a class="elsevierStyleCrossRefs" href="#bib0175">4–6</a> Others, however, claim that salvaged blood can be heparinised and mixed with anaesthetic drugs, and this can alter haemoglobin and haematocrit levels.<a class="elsevierStyleCrossRefs" href="#bib0190">7–10</a> Reinfused red blood cells (RBC) are rich in haemoglobin and haematocrit but poor in 2,3-diphosphoglycerate (2,3 DPG), which slows the transfer of oxygen to tissues.<a class="elsevierStyleCrossRef" href="#bib0210">11</a> These red blood cells contain no plasma, platelets or clotting factors, and thus trigger an inflammatory cascade that causes haematological abnormalities,<a class="elsevierStyleCrossRefs" href="#bib0190">7,8</a> such as coagulopathy,<a class="elsevierStyleCrossRef" href="#bib0215">12</a> and increases morbidity by 2–8%.<a class="elsevierStyleCrossRef" href="#bib0220">13</a> In this context, it is impossible to predict the platelet and plasma content of reinfused blood from the CS,<a class="elsevierStyleCrossRef" href="#bib0225">14</a> and this limits it clinical usefullness.<a class="elsevierStyleCrossRef" href="#bib0230">15</a> The evidence shows that further studies are needed to determine the validity<a class="elsevierStyleCrossRefs" href="#bib0235">16–18</a> and clinical effects of such red blood cells transfusion in patients, such as significantly longer partial thromboplastin times.<a class="elsevierStyleCrossRef" href="#bib0165">2</a> These theoretical issues have been raised in earlier studies in which no CS protocol is used.<a class="elsevierStyleCrossRef" href="#bib0245">18</a> We aimed to compare the blood count values of patients both before and 12h after reinfusion of RBCs from the cell saver. We hypothesised that reinfusing RBCs processed in the CS in cardiac surgery patient causes changes in their baseline blood count values.Material and methodsThis is an observational analytical study in patients scheduled for cardiac surgery by the Cardiovascular Surgery Department and Heart Unit between January 1 and December 31, 2016. All data were obtained from the surgery scheduling form.Study subjectsAll patients that had undergone surgery using the Fresenius Continuous Autologous Transfusion System (CATS®) were eligible for the study. Inclusion criteria were: willingness to participate and sign an informed consent form after receiving a verbal and written explanation of the characteristics of the study, aged over 18 years, having undergone aortic valve surgery, mitral, tricuspid or coronary bypass using the CATS. Any patient in whom CATS was not used based on the indications for surgery (implantation of a pacemaker, implantation of a cardioverter-defibrillator, and vascular surgery), did not meet study criteria and were excluded.All patients were prepared for surgery using the same, standard, procedure: on admission to the operating room, the patient was placed in the supine position and heart rate, blood pressure, oxygen saturation and depth of anaesthesia (using the bispectral [BIS] index) were monitored. Peripheral (ProtectIV Plus 18 G) and arterial (Leadercath 3 fr) lines were placed in the left arm, a double-lumen blue FlexTip (Arrow 7 fr) central venous catheter was placed in the subclavian vein, and a foley catheter (Rusch Gold ch 14) was placed. The same general anaesthesia protocol was used in all patients; non-selective intubation using a standard tube and intravenous drugs at patient-adjusted doses.The surgical approach was the same in all cases. Median sternotomy was performed to facilitate large vessels cannulation and connection to the cardiopulmonary bypass (CPB) pump following administration of sodium heparin 2IU/kg into the right atrium. After confirming activated clotting times (ACT) of over 200s, the aorta was clamped and cardioplegia was induced with pharmacological agents and cold cardioplegic solution. After separation from the CPB pump, protamine (a heparin antagonist) was administered at a ratio of 1:1 with heparin.The CS was prepared and used in the same way in all patients. The CS circuit was primed and purged with 3000ml saline 0.9% mixed with 30,000IU of sodium heparin to prevent clotting of blood entering the machine. Blood shed from the surgical field was salvaged using a double lumen Yankauer suction tip with a bulbous head and adjustable vacuum pressure of −20cm H2O. Salvaged blood was collected in a reservoir from where it was transferred to a washing chamber for processing (separating RBCs from the other blood components) at an average speed of 2000RPM, depending on the program selected (high quality wash). After processing, a bag containing only RBCs was obtained and reinfused after surgery. The other blood components discarded by the CS were collected in another bag. Sternal closure was performed using non-absorbable stainless steel monofilament (V-40).Sociodemographic variables were collected: age, sex, body mass index (BMI), medical diagnosis (aortic, mitral or tricuspid valve disease and coronary arteriosclerosis), and surgical intervention on arrival of the patient in the operating room. All these parameters were obtained from the patient's medical history.Haematological variables were also collected: haemoglobin (g/dl), haematocrit (%), platelets (103/μl), total proteins (g/dl), prothrombin time (PT [s]), activated partial thromboplastin time (aPTT [s]), coagulation times (ACT [s]), international normalised ratio (INR [s]), red blood cell distribution width (RDW [%]), C-reactive protein (CRP [mg/l]) and D-dimer (μg/l) at 2 time points: prior to reinfusion and 12h after reinfusion. These data were obtained from the results of the standard preoperative complete blood count contained in the patient's electronic medical record.CS variables: haemoglobin (gr/dl) haematocrit (%) obtained from samples taken from the collection reservoir and reinfusion bag and analysed using the approved Cobas b 221 testing system installed in the operating room; processing time expressed in minutes; volume of blood salvaged and red blood cells obtained; volume of blood washed and discarded. All these variables were expressed in ml, and were obtained from the digital screen of the CS machine after use.Statistical analysisAll data were analysed using SPSS version 22.0. Numerical variables were expressed as mean and standard deviation. Continuous variables were tested for statistical significance using the Student's t test. The non-parametric Mann–Whitney U test was used to compare differences between 2 ordinal variables. A significance level of p<0.05 was used in all tests, with a sampling error of 3%.Ethical mattersThe study was carried out in accordance with the principles of the Declaration of Helsinki and the provisions of the Spanish Protection of Personal Data Act (15/1999 of December 13) and its implementing regulation (RD 1720/2007 of December 21). The study was explained in detail (verbally) to all patients. Personal data were anonymised, and patients were identified solely by a numeric code. All signed informed consent forms were stored safely and were accessible only to the researcher. The study was approved by the Institutional Review Board.ResultsOf the 789 (100%) patients scheduled for cardiac surgery, 479 (60.7%) met the inclusion criteria and were duly included, and 310 (39.3%) were excluded because CS was not used for the following reasons: 181 (23%) due to pacemaker insertion, 89 (11.3%) due to insertion of an implantable cardioverter defibrillator (ICD), and 40 (5%) due to vascular surgery (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Patient characteristics were: average age 63 years; mostly men (56.1%) with mean BMI 25; mostly undergoing aortic valve surgery (75%) (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Mean CS parameters were: salvaged blood volume 1910ml (minimum 101ml; maximum 2210ml); volume of RBCs obtained and reinfused 605ml (minimum 52ml; maximum 816ml) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>With regard to haematological values, a statistically significant increase in haemoglobin (9.5–12.5g/dl) (p=0.008), haematocrit (26–38%) (p=0.014) CRP (8.5–22.1mg/l) (p=0.006), and D-dimer (493.3–875.5μg/l) (p=0.008) levels was observed after reinfusion, while platelet count (214.2–164.2×103/μl) and total protein (7.6–5.1g/dl) were lower after reinfusion. The remaining values were similar before and after reinfusion with salvaged blood, so the main outcome measures were statistically significant (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>DiscussionThe results of this study show that haematological changes occur in patients before and after reinfusion of salvaged blood. The reinfusion of haemoglobin- and haematocrit-rich RBCs consequently increased the patient's own baseline haematological values during the first 12 postoperative hours. The reinfusion of RBCs depletes the patient's own reserves, which explains the decrease in platelet and total protein levels. The increase in D-dimer and CRP levels after reinfusion raises the possibility that small quantities of fibrin may be generated (formed during the resorption of a haematoma or during haemorrhage), thus increasing the risk of thrombosis or blood clots.<a class="elsevierStyleCrossRef" href="#bib0250">19</a>After analysing the different safety alerts regarding the use of CS, the Grupo de Estudios Multidisciplinares (Multidisciplinary Studies Group) called for complementary studies to analyse the effect of reinfused salvaged blood on haematological values.<a class="elsevierStyleCrossRef" href="#bib0255">20</a> The Group also analysed the costs and benefits of salvaged blood reinfusion in other surgeries, such as obstetric,<a class="elsevierStyleCrossRef" href="#bib0260">21</a> gynaecological<a class="elsevierStyleCrossRef" href="#bib0265">22</a> or orthopaedic<a class="elsevierStyleCrossRef" href="#bib0270">23</a> procedures, based on existing studies.<a class="elsevierStyleCrossRefs" href="#bib0165">2,11</a>Salaria et al.<a class="elsevierStyleCrossRef" href="#bib0275">24</a> showed that RBCs from CS are subject to storage lesions. After reinfusion, blood analyses showed RBC cell membrane deformity in proportion to the volume of reinfused salvaged blood. However, the authors do not identify these lesions or the possible haematological abnormalities that result from such reinfusion.A number of invasive Mycobacterium chimaera infections (originating in cardiopulmonary bypass pumps) have been reported after open-heart surgery. Collecting blood that has passed through these pumps might expose the salvaged blood to these bacteria.<a class="elsevierStyleCrossRef" href="#bib0280">25</a> This has also been reported in other studies.<a class="elsevierStyleCrossRef" href="#bib0285">26</a> However, these studies do not determine the presence of these bacteria in CS units or the possible haematological complications that can arise in patients reinfused with salvaged blood. True enough, some studies describe the administration of 10μg/ml of vancomycin in the CS reservoir to eliminate any possible bacterial contamination,<a class="elsevierStyleCrossRef" href="#bib0290">27</a> but they do not evaluate the haematological abnormalities that could arise in the patient before or after reinfusion of salvaged RBCs.Gabel et al.<a class="elsevierStyleCrossRef" href="#bib0295">28</a> support the use of salvaged blood by showing that CS processing mitigated the impaired platelet aggregability typical of unprocessed wound blood. However, they also observed that CS processing reduced the platelet count.In other surgeries, such as orthopaedic procedures (patients with acetabular fractures), CS is associated with postoperative complications, and is not recommended.<a class="elsevierStyleCrossRef" href="#bib0300">29</a> However, in contrast to our study, other authors do not describe in detail the postoperative haematological changes (PT, aPTT, INR, total proteins, CRP or D-dimer, among other values) caused by CS.Scientific evidence has shown that reinfusion of RBCs from CS can be harmful. Marcheix et al.,<a class="elsevierStyleCrossRef" href="#bib0305">30</a> for example, described a decrease in complement activation in patients undergoing coronary surgery, while Sandoval et al.,<a class="elsevierStyleCrossRef" href="#bib0310">31</a> found a statistically significant increase in interleukins (IL) IL-1, IL-2, IL-4, IL-6, IL-8, IL-10 and tumour necrosis factor in patients receiving salvaged blood. However, none of these studies analysed changes in blood values before and after reinfusion.Our study has some design limitations, namely, the absence of a control group not receiving blood from CS. This would have allowed us to compare the haematological values between the control and intervention groups.In this context, our study has enriched scientific knowledge by identifying some of the haematological changes occurring after reinfusion of CS-processed blood; we believe our findings will help improve the postoperative care of patients receiving such transfusions.Finally, our findings have both practical and investigational implications for the use of CS, as they will enable clinicians to prescribe the correct treatment (pharmacological, blood transfusions or other procedures) based on the haematological changes presented by these patients.Time will, no doubt, refocus the debate following publication of these findings. We hope this will encourage researchers to carry out other comparative or cohort studies to associate the use of CS with complications during the postoperative period, and thus improve postoperative care and address the concerns of scientific associations and other institutions regarding the use of CS.Based on our results, we conclude that patients receiving reinfusion of CS-processed blood present increased levels of haemoglobin, haematocrit, CRP and D-dimer, and decreased platelet count and total proteins during the postoperative period.Ethical disclosuresProtection of human and animal subjectsThe authors declare that no experiments were performed on humans or animals for this study.Confidentiality of dataThe authors declare that they have followed the protocols implemented in their place of work regarding the use of patient data in publications.Right to privacy and informed consentThe authors have obtained the informed consent of all patients and/or subjects included in this manuscript. The informed consent forms can be obtained from the author for correspondence.Conflict of interestsNone declared." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres982050" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec949628" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres982051" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec949627" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Study subjects" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Statistical analysis" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Ethical matters" ] ] ] 6 => array:2 [ "identificador" => "sec0030" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 8 => array:3 [ "identificador" => "sec0040" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0050" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0055" "titulo" => "Right to privacy and informed consent" ] ] ] 9 => array:2 [ "identificador" => "sec0060" "titulo" => "Conflict of interests" ] 10 => array:2 [ "identificador" => "xack332728" "titulo" => "Acknowledgements" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-04-20" "fechaAceptado" => "2017-09-12" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec949628" "palabras" => array:4 [ 0 => "Cell saver" 1 => "Haematology" 2 => "Reinfusion" 3 => "Cardiac" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec949627" "palabras" => array:4 [ 0 => "Recuperador celular" 1 => "Hematología" 2 => "Reinfusión" 3 => "Cardíaca" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveThere are studies that declare blood recovered with the autotransfusion system that is potentially heparinised and mixed with other drugs, can cause haematological alterations in the patient, according to existing evidence. The proposal was to compare the haematological values of the patients before reinfusing red blood cells from the cell saver and 12h after reinfusion. Material and methodsObservational analytical study of 479 patients who underwent cardiac surgery where the cell saver was used. Haematological variables were collected before reinfusion and 12h after reinfusion. ResultsStatistically significant haematological values before reinfusion and 12h after reinfusion were: haemoglobin (9.5–12.5g/dL), haematocrit (26–38%), platelets (214.2–164.2103/μL), total proteins (7.6–5.1g/dL), PCR (8.5–22.1mg/L) and D-dimer (493.3–875.5μg/L) with p<0.05. ConclusionsWith the use of the cell saver an increase was observed of haemoglobin, haematocrit, PCR and D-dimer values together with a decrease in platelet and total protein numbers." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivoExisten estudios que declaran la sangre recuperada con el sistema de autotransfusión que está potencialmente heparinizada y mezclada con otros fármacos, lo que puede provocar alteraciones hematológicas en el paciente, a tenor de la evidencia existente. Se planteó comparar los valores hematológicos de los pacientes antes de reinfundir glóbulos rojos procedentes del recuperador celular y 12h después de la reinfusión. Material y métodosEstudio analítico observacional en el cual se estudiaron 479pacientes intervenidos de cirugía cardíaca donde se utilizó el recuperador celular. Se recogieron variables hematológicas antes de reinfundir y 12h después de haber sido reinfundidos. ResultadosLos valores hematológicos estadísticamente significativos antes de la reinfusión y 12h después de la reinfusión fueron: hemoglobina (9,5 a 12,5g/dl), hematocrito (26 a 38%), plaquetas (214,2 a 164,2103/μl), proteínas totales (7,6 a 5,1g/dl), PCR (8,5 a 22,1mg/l) y dímero-D (493,3 a 875,5μg/l), con p<0,05. ConclusionesCon el uso del recuperador celular se observó un aumento de los valores de hemoglobina, hematocrito, PCR y dímero-D junto con la disminución de cifras de plaquetas y proteínas totales." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Luque-Oliveros M. Alteraciones hematológicas en el paciente cardíaco tras uso de un sistema de autotransfusión. Rev Esp Anestesiol Reanim. 2018;65:74–80." ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1881 "Ancho" => 2833 "Tamanyo" => 198084 ] ] "descripcion" => array:1 [ "en" => "Flowchart." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "BMI: body mass index; CD-Sx: clinical diagnosis-surgical intervention; Fr (%): frequency (percentage)." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean Fr (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Standard deviation \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Minimum \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Maximum \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Gender</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Men \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">269 (56.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Women \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">210 (43.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">78 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">18–29 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">30–45 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (2.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">46–65 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">421 (87.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">>65 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45 (9.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><18.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (0.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">18.5–24.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">127 (26.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">25–29.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">331 (69.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">>30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (1.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">DC-Sx</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Aortic valve \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">364 (76) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mitral valve \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tricuspid valve \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Coronary art \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1662954.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "BMI: <18.5 (low weight); 18.5–24.9 (normal); 25–29.9 (overweight), and >30 (obese)." ] ] ] "descripcion" => array:1 [ "en" => "Characteristics of study subjects." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Hb: haemoglobin; Htc: haematocrit." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Standard deviation \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Minimum \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Maximum \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">In reservoir</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hb (g/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Htc (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">In reinfusion bag</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hb (g/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Htc (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Volumes</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Waste (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5647 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1597.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10,500 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Washed (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3363 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1016.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1300 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7950 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Processing</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Time (s) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">51 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1662953.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Mean values in CS blood." ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "Quantitative variables are expressed as mean and standard deviation, unless otherwise indicated.Values in bold indicate significant differences, p<0.05.ACT: activated clotting time; aPTT: activated partial thromboplastin time; CRP: C-reactive protein; Hb: haemoglobin; Htc: haematocrit; INR: international normalised ratio; PT: prothrombin time; RDW: red blood cell distribution width." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Parameters \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Before reinfusion (n=479) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Standard deviation \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">12h after reinfusion (n=479) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Standard deviation \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">U Mann–Whitney Student's t test<a class="elsevierStyleCrossRef" href="#tblfn0010">a</a> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hb \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.008<a class="elsevierStyleCrossRef" href="#tblfn0010">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Htc \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.014 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Platelets \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">214.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">164.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.019 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total protein \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.011 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.717 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">aPTT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.13 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ACT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">200.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">85.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">191.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">73.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.32 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">INR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.24 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">RDW \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.124 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CRP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.006 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">D-Dimer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">493.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">174.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">875.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">268.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.008 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1662955.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "a" "nota" => "Student's t test." ] ] ] "descripcion" => array:1 [ "en" => "Mean haematological values in study patients." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib0160" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2011 ACCF/AHA guideline for coronary artery bypass graft surgery: executive summary" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines" "etal" => true "autores" => array:6 [ 0 => "L.D. Hillis" 1 => "P. Smith" 2 => "P.K. Anderson" 3 => "J.L. Bittl" 4 => "J.A. Briges" 5 => "C. Byrne" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIR.0b013e31823b5fee" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2011" "volumen" => "124" "paginaInicial" => "2610" "paginaFinal" => "2642" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22064600" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0165" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists Blood Conservation Clinical Practice Guidelines" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V.A. Ferraris" 1 => "J. Brown" 2 => "G. Despotis" 3 => "J. Hammon" 4 => "T. Brett" 5 => "S. Saha" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.athoracsur.2010.11.078" "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2011" "volumen" => "91" "paginaInicial" => "944" "paginaFinal" => "982" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21353044" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0170" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Safety of preoperative blood donation (for autotransfusion) for cardiac surgery patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E. Santoni" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Tranfusion" "fecha" => "2012" "volumen" => "33" "paginaInicial" => "91" "paginaFinal" => "95" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0175" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pretransfusion comparison of dialyser-based hemoconcentrator with cell saver system for perioperative cell salvage" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Garp" 1 => "A. Malhotra" 2 => "M. Desai" 3 => "P. Sharma" 4 => "A.K. Bishnoi" 5 => "P. Tripathi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Innovations (Phila)" "fecha" => "2015" "volumen" => "10" "paginaInicial" => "334" "paginaFinal" => "341" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0180" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implementation of an obstetric cell salvage service in a tertiary women's hospital" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. Lew" 1 => "S. Tagore" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.11622/smedj.2015121" "Revista" => array:6 [ "tituloSerie" => "Singapore Med J" "fecha" => "2015" "volumen" => "56" "paginaInicial" => "445" "paginaFinal" => "449" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26311910" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0185" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cell salvage during coronary artery bypass surgery and allogenic blood exposure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Al-Mandhari" 1 => "M.M. Maddali" 2 => "M.J. Al-Brahrani" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0218492315592788" "Revista" => array:7 [ "tituloSerie" => "Asian Cardiovasc Thorac Ann" "fecha" => "2015" "volumen" => "23" "paginaInicial" => "913" "paginaFinal" => "916" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26113735" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0195670116000888" "estado" => "S300" "issn" => "01956701" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0190" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of three blood-processing techniques during and after cardiopulmonary bypass" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Sutton" 1 => "J. Kratz" 2 => "F. Spinale" 3 => "F. Crawford" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "1993" "volumen" => "56" "paginaInicial" => "938" "paginaFinal" => "943" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8215672" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0195" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.A. Kozek-Langenecker" 1 => "A. Afshari" 2 => "P. Albaladejo" 3 => "C. Aldecoa" 4 => "E. de Robertis" 5 => "D.C. Filipescu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/EJA.0b013e32835f4d5b" "Revista" => array:6 [ "tituloSerie" => "Eur J Anaesthesiol" "fecha" => "2013" "volumen" => "30" "paginaInicial" => "270" "paginaFinal" => "382" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23656742" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0200" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sangre y cirugía. Estrategia de ahorro en cirugía cardíaca" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Flórez" 1 => "L. Prieto" 2 => "L. Maroto" 3 => "J. Bustamante" 4 => "T. Cubero" 5 => "M. Fernández" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Investig Quir" "fecha" => "2011" "volumen" => "14" "paginaInicial" => "89" "paginaFinal" => "114" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0205" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Argatroban for anticoagulation of a blood salvage system—an ex vivo study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Beiderlinden" 1 => "C. Brau" 2 => "S. di Grazia" 3 => "M. Wehmeier" 4 => "T.A. Treschan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12871-016-0204-3" "Revista" => array:5 [ "tituloSerie" => "BMC Anesthesiol" "fecha" => "2016" "volumen" => "16" "paginaInicial" => "37" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27418211" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0210" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Thrombocytopenia in critically ill patients: a review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Chaari" 1 => "F. Medhioub" 2 => "M. Samet" 3 => "K. Chtara" 4 => "R. Allala" 5 => "H. Dammak" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Trends Anaesth Crit Care" "fecha" => "2011" "volumen" => "1" "paginaInicial" => "199" "paginaFinal" => "202" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0215" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of mechanical cell savage on red blood cell aggregation, deformability, and 2,3-diphosphoglycerate in patients undergoing cardiac surgery with cardiopulmonary bypass" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Y.J. Gu" 1 => "W.J. Vermeijden" 2 => "A.J. de Vries" 3 => "J.A. Hagenaars" 4 => "R. Graaff" 5 => "W. van Oeveren" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.athoracsur.2008.07.052" "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2008" "volumen" => "86" "paginaInicial" => "1570" "paginaFinal" => "1575" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19049752" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0220" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Morbidity of bleeding after cardiac surgery: is it blood transfusion, reoperation for bleeding, or both?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Vivacqua" 1 => "C.G. Koch" 2 => "A.M. Yousuf" 3 => "E.R. Nowicki" 4 => "P.L. Houghtaling" 5 => "E.H. Blackstone" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.athoracsur.2011.03.105" "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2011" "volumen" => "91" "paginaInicial" => "1780" "paginaFinal" => "1790" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21619974" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0225" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Discriminatory power of the intraoperative cell salvage use in the prediction of platelet and plasma transfusion in patients undergoing cardiac surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Al-Khabori" 1 => "A.Z. Al-Riyami" 2 => "B. Baskaran" 3 => "M. Siddiqi" 4 => "H. Al-Sabti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.transci.2015.03.019" "Revista" => array:6 [ "tituloSerie" => "Transfus Apher Sci" "fecha" => "2015" "volumen" => "53" "paginaInicial" => "208" "paginaFinal" => "212" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25863410" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0230" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Changes in cerebral oxygenation during transfusion therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Hakin" 1 => "D. Tumin" 2 => "D.P. Martin" 3 => "W. Samora" 4 => "A.C. Beebe" 5 => "J.E. Klamar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Extra Corpor Technol" "fecha" => "2016" "volumen" => "48" "paginaInicial" => "173" "paginaFinal" => "178" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27994257" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0235" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reinfusate heparin concentrations produced by two autotransfusion systems" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "W.F. Buys" 1 => "M. Buys" 2 => "A.L. Levin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.jvca.2016.06.014" "Revista" => array:6 [ "tituloSerie" => "J Cardiothorac Vasc Anesth" "fecha" => "2017" "volumen" => "31" "paginaInicial" => "90" "paginaFinal" => "98" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27591910" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0240" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Characteristics and quality of intra-operative cell savage in paediatric scoliosis surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Perez" 1 => "E. Gredilla" 2 => "J. de Vicente" 3 => "R. Navarro" 4 => "F. Gilsanz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.redar.2015.05.008" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Anestesiol Reanim" "fecha" => "2016" "volumen" => "63" "paginaInicial" => "78" "paginaFinal" => "83" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26162899" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0245" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influencia del recuperador celular en la respuesta inflamatoria y en las necesidades transfusionales en cirugía cardíaca: estudio prospectivo aleatorizado" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Reyes" 1 => "M.A. Prieto" 2 => "J. Bustamante" 3 => "P. Álvarez" 4 => "S. Badia" 5 => "A. Sarraj" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Cir Cardiovasc" "fecha" => "2010" "volumen" => "17" "numero" => "Suppl. 1" "paginaInicial" => "37" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0250" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Papel de los dímeros D en la enfermedad venosa tromboembólica (EVT)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Sitbon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Bioquím Clin Latinoam" "fecha" => "2010" "volumen" => "44" "paginaInicial" => "101" "paginaFinal" => "108" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0255" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Foro de debate: seguridad de las alternativas a la transfusión alogénica en el paciente quirúrgico y/o crítico" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Muñoz" 1 => "E. Bisbe" 2 => "E. Basora" 3 => "J.A. García" 4 => "A. Gómez" 5 => "S.R. Leal-Noval" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2015.05.006" "Revista" => array:6 [ "tituloSerie" => "Med Intensiva" "fecha" => "2015" "volumen" => "39" "paginaInicial" => "552" "paginaFinal" => "562" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26183121" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0260" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The economic benefits of cell salvage in obstetric haemorrhage" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Brearton" 1 => "A. Bhalla" 2 => "S. Mallaiah" 3 => "P. Barclay" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijoa.2012.05.003" "Revista" => array:6 [ "tituloSerie" => "Int J Obstet Anesth" "fecha" => "2012" "volumen" => "21" "paginaInicial" => "329" "paginaFinal" => "333" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22858041" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0265" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The use of cell salvage in women undergoing cesarean hysterectomy for abnormal placentation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Elagamy" 1 => "A. Abdelaziz" 2 => "M. Ellaithy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijoa.2013.05.007" "Revista" => array:6 [ "tituloSerie" => "Int J Obstet Anesth" "fecha" => "2013" "volumen" => "22" "paginaInicial" => "289" "paginaFinal" => "293" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23958277" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0270" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Indications and outcomes of cell saver in adolescent scoliosis correction surgery: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "N. Stone" 1 => "V. Sardana" 2 => "P. Missiuna" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Spine (Phila Pa 1976)" "fecha" => "2017" "volumen" => "42" "paginaInicial" => "E363" "paginaFinal" => "E370" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0275" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impaired red blood cell deformability after transfusion of stored allogenic blood but not autologous salvaged blood in cardiac surgery patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "O.N. Salaria" 1 => "V.M. Barodka" 2 => "C.W. Hogue" 3 => "D.E. Bekowitz" 4 => "P.M. Ness" 5 => "J.O. Wasey" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1213/ANE.0000000000000227" "Revista" => array:6 [ "tituloSerie" => "Anesth Analg" "fecha" => "2014" "volumen" => "118" "paginaInicial" => "1179" "paginaFinal" => "1187" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24806142" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0280" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reemergence of Mycobacterium chimaera in heater-cooler units despite intensified cleaning and disinfection protocol" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Schreiber" 1 => "S. Kuster" 2 => "B. Hasse" 3 => "C. Bayard" 4 => "C. Ruegg" 5 => "P. Kohler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3201/eid2210.160925" "Revista" => array:6 [ "tituloSerie" => "Emerg Infect Dis" "fecha" => "2016" "volumen" => "22" "paginaInicial" => "1830" "paginaFinal" => "1833" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27649345" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0285" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Notes from the field: Mycobacterium chimaera contamination of heater cooler devices used in cardiac surgery-United States" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Perkins" 1 => "A. Lawsin" 2 => "N. Hasan" 3 => "M. Strong" 4 => "A. Halpin" 5 => "R. Rodger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.15585/mmwr.mm6540a6" "Revista" => array:6 [ "tituloSerie" => "MMWR Morb Mortal Wkly Rep" "fecha" => "2016" "volumen" => "65" "paginaInicial" => "1117" "paginaFinal" => "1118" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27740609" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0290" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vancomycin added to the wash solution of the cell-saver. Effect on bacterial contamination" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Perez" 1 => "E. Gredilla" 2 => "J. de Vicente" 3 => "R. Navaroo" 4 => "F. Gilsanz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.redar.2016.10.002" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Anestesiol Reanim" "fecha" => "2017" "volumen" => "64" "paginaInicial" => "185" "paginaFinal" => "191" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28094033" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0295" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cell saver processing mitigates the negative effects of wound blood on platelet function" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Gabel" 1 => "C.J. Malm" 2 => "V. Radulovic" 3 => "C. Shams Hakimi" 4 => "M. Westerberg" 5 => "A. Jeppsson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Anesthesiol Scand" "fecha" => "2016" "volumen" => "60" "paginaInicial" => "901" "paginaFinal" => "909" "itemHostRev" => array:3 [ "pii" => "S0140673600028142" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0300" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cell saver use in acetabular surgery: does approach matter?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Firoozabi" 1 => "A. Swenson" 2 => "C. Kleweno" 3 => "M.C. Routt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/BOT.0000000000000292" "Revista" => array:6 [ "tituloSerie" => "J Orthop Trauma" "fecha" => "2015" "volumen" => "29" "paginaInicial" => "349" "paginaFinal" => "353" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25635358" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0305" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of pericardial blood processing on postoperative inflammation and the complement pathways" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Marcheix" 1 => "M. Carrier" 2 => "C. Martel" 3 => "M. Cossette" 4 => "M. Pellerin" 5 => "D. Bouchard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.athoracsur.2007.08.050" "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2008" "volumen" => "85" "paginaInicial" => "530" "paginaFinal" => "535" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18222258" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0310" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A cytokine analysis of the effect of cell saver on blood in coronary bypass surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Sandoval" 1 => "S. Alrawi" 2 => "M. Samee" 3 => "M. Same" 4 => "R. Satheesan" 5 => "R. Raju" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Heart Surg Forum" "fecha" => "2001" "volumen" => "4" "paginaInicial" => "113" "paginaFinal" => "117" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11544618" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack332728" "titulo" => "Acknowledgements" "texto" => "We would like to thank Dr. Polo for his statistical analysis and advice." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006500000002/v1_201802090832/S2341192917302044/v1_201802090832/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006500000002/v1_201802090832/S2341192917302044/v1_201802090832/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192917302044?idApp=UINPBA00004N"]

Statistics

Original article

Haematological alterations in the cardiac patient after use of an autotransfusion system

Alteraciones hematológicas en el paciente cardíaco tras uso de un sistema de autotransfusión

M. Luque-Oliveros

Bloque Quirúrgico y Anestesia Reanimación, Hospital Universitario Virgen Macarena, Sevilla, Spain

Read

Times
was read the article

Total PDF

Total HTML

Share statistics

 array:24 [
  "pii" => "S2341192917302044"
  "issn" => "23411929"
  "doi" => "10.1016/j.redare.2017.12.004"
  "estado" => "S300"
  "fechaPublicacion" => "2018-02-01"
  "aid" => "862"
  "copyright" => "Sociedad Espa&#241;ola de Anestesiolog&#237;a&#44; Reanimaci&#243;n y Terap&#233;utica del Dolor"
  "copyrightAnyo" => "2017"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Revista Espa&#241;ola de Anestesiolog&#237;a y Reanimaci&#243;n &#40;English Version&#41;. 2018;65:74-80"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 1
    "PDF" => 1
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0034935617302116"
      "issn" => "00349356"
      "doi" => "10.1016/j.redar.2017.09.003"
      "estado" => "S300"
      "fechaPublicacion" => "2018-02-01"
      "aid" => "862"
      "copyright" => "Sociedad Espa&#241;ola de Anestesiolog&#237;a&#44; Reanimaci&#243;n y Terap&#233;utica del Dolor"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Rev Esp Anestesiol Reanim. 2018;65:74-80"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 100
        "formatos" => array:2 [
          "HTML" => 84
          "PDF" => 16
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Alteraciones hematol&#243;gicas en el paciente card&#237;aco tras uso de un sistema de autotransfusi&#243;n"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "74"
            "paginaFinal" => "80"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Haematological alterations in the cardiac patient after use of an autotransfusion system"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1881
                "Ancho" => 2833
                "Tamanyo" => 215806
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Diagrama de flujo&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46; Luque-Oliveros"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Luque-Oliveros"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2341192917302044"
          "doi" => "10.1016/j.redare.2017.12.004"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192917302044?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935617302116?idApp=UINPBA00004N"
      "url" => "/00349356/0000006500000002/v1_201801100532/S0034935617302116/v1_201801100532/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2341192917302111"
    "issn" => "23411929"
    "doi" => "10.1016/j.redare.2017.12.008"
    "estado" => "S300"
    "fechaPublicacion" => "2018-02-01"
    "aid" => "867"
    "copyright" => "Sociedad Espa&#241;ola de Anestesiolog&#237;a&#44; Reanimaci&#243;n y Terap&#233;utica del Dolor"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Revista Espa&#241;ola de Anestesiolog&#237;a y Reanimaci&#243;n &#40;English Version&#41;. 2018;65:81-9"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2
      "formatos" => array:2 [
        "HTML" => 1
        "PDF" => 1
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Diaphragmatic thickness ratio &#40;inspiratory&#47;expiratory&#41; as a diagnostic method of diaphragmatic palsy associated with interscalene block"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "81"
          "paginaFinal" => "89"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "La ratio de grosor diafragm&#225;tico &#40;inspiratorio&#47;espiratorio&#41; como m&#233;todo diagn&#243;stico de par&#225;lisis diafragm&#225;tica asociada al bloqueo interesc&#225;lenico"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1470
              "Ancho" => 1589
              "Tamanyo" => 65987
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Reduction of spirometric parameters observed at 20<span class="elsevierStyleHsp" style=""></span>min after interscalene blockade&#44; with respect to baseline levels&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "V&#46;M&#46; L&#243;pez Esc&#225;rraga, K&#46; Dubos Espa&#241;a, R&#46;H&#46; Castillo Bustos, L&#46; Peidr&#243;, S&#46; Sastre, X&#46; Sala-Blanch"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "V&#46;M&#46;"
              "apellidos" => "L&#243;pez Esc&#225;rraga"
            ]
            1 => array:2 [
              "nombre" => "K&#46;"
              "apellidos" => "Dubos Espa&#241;a"
            ]
            2 => array:2 [
              "nombre" => "R&#46;H&#46;"
              "apellidos" => "Castillo Bustos"
            ]
            3 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Peidr&#243;"
            ]
            4 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Sastre"
            ]
            5 => array:2 [
              "nombre" => "X&#46;"
              "apellidos" => "Sala-Blanch"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0034935617302165"
        "doi" => "10.1016/j.redar.2017.09.008"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935617302165?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192917302111?idApp=UINPBA00004N"
    "url" => "/23411929/0000006500000002/v1_201802090832/S2341192917302111/v1_201802090832/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2341192917302147"
    "issn" => "23411929"
    "doi" => "10.1016/j.redare.2017.11.015"
    "estado" => "S300"
    "fechaPublicacion" => "2018-02-01"
    "aid" => "877"
    "copyright" => "Sociedad Espa&#241;ola de Anestesiolog&#237;a&#44; Reanimaci&#243;n y Terap&#233;utica del Dolor"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Revista Espa&#241;ola de Anestesiolog&#237;a y Reanimaci&#243;n &#40;English Version&#41;. 2018;65:69-73"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial article</span>"
      "titulo" => "Non-invasive multi-parametric cardiorespiratory assessment of the hemodynamically unstable patient"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "69"
          "paginaFinal" => "73"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Valoraci&#243;n cardiorrespiratoria no invasiva y multiparam&#233;trica del paciente hemodin&#225;micamente inestable"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46; Perel"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Perel"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S003493561730244X"
        "doi" => "10.1016/j.redar.2017.11.002"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S003493561730244X?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192917302147?idApp=UINPBA00004N"
    "url" => "/23411929/0000006500000002/v1_201802090832/S2341192917302147/v1_201802090832/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Haematological alterations in the cardiac patient after use of an autotransfusion system"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "74"
        "paginaFinal" => "80"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "M&#46; Luque-Oliveros"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Luque-Oliveros"
            "email" => array:1 [
              0 => "mluque5&#64;us&#46;es"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Bloque Quir&#250;rgico y Anestesia Reanimaci&#243;n&#44; Hospital Universitario Virgen Macarena&#44; Sevilla&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Alteraciones hematol&#243;gicas en el paciente card&#237;aco tras uso de un sistema de autotransfusi&#243;n"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1881
            "Ancho" => 2833
            "Tamanyo" => 198084
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flowchart&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The American Heart Association&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">1</span></a> the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">2</span></a> have described the cell saver &#40;CS&#41; autotransfusion system as an alternative to blood transfusion in cardiac surgery&#46; The CS is an electronic device that salvages intraoperative blood loss and processes it for reinfusion&#46; The process consists of separating and washing the red blood cells with physiological saline before reinfusion&#46; The remaining contents&#44; namely&#44; plasma&#44; platelets&#44; clotting factors and products from the surgical site&#44; are discarded&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">3</span></a> Several studies have highlighted the safety&#44; efficacy and efficiency of the CS&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">4&#8211;6</span></a> Others&#44; however&#44; claim that salvaged blood can be heparinised and mixed with anaesthetic drugs&#44; and this can alter haemoglobin and haematocrit levels&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">7&#8211;10</span></a> Reinfused red blood cells &#40;RBC&#41; are rich in haemoglobin and haematocrit but poor in 2&#44;3-diphosphoglycerate &#40;2&#44;3 DPG&#41;&#44; which slows the transfer of oxygen to tissues&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">11</span></a> These red blood cells contain no plasma&#44; platelets or clotting factors&#44; and thus trigger an inflammatory cascade that causes haematological abnormalities&#44;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">7&#44;8</span></a> such as coagulopathy&#44;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">12</span></a> and increases morbidity by 2&#8211;8&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">13</span></a> In this context&#44; it is impossible to predict the platelet and plasma content of reinfused blood from the CS&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a> and this limits it clinical usefullness&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">15</span></a> The evidence shows that further studies are needed to determine the validity<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">16&#8211;18</span></a> and clinical effects of such red blood cells transfusion in patients&#44; such as significantly longer partial thromboplastin times&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">2</span></a> These theoretical issues have been raised in earlier studies in which no CS protocol is used&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">18</span></a> We aimed to compare the blood count values of patients both before and 12<span class="elsevierStyleHsp" style=""></span>h after reinfusion of RBCs from the cell saver&#46; We hypothesised that reinfusing RBCs processed in the CS in cardiac surgery patient causes changes in their baseline blood count values&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">This is an observational analytical study in patients scheduled for cardiac surgery by the Cardiovascular Surgery Department and Heart Unit between January 1 and December 31&#44; 2016&#46; All data were obtained from the surgery scheduling form&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study subjects</span><p id="par0015" class="elsevierStylePara elsevierViewall">All patients that had undergone surgery using the Fresenius Continuous Autologous Transfusion System &#40;CATS<span class="elsevierStyleSup">&#174;</span>&#41; were eligible for the study&#46; Inclusion criteria were&#58; willingness to participate and sign an informed consent form after receiving a verbal and written explanation of the characteristics of the study&#44; aged over 18 years&#44; having undergone aortic valve surgery&#44; mitral&#44; tricuspid or coronary bypass using the CATS&#46; Any patient in whom CATS was not used based on the indications for surgery &#40;implantation of a pacemaker&#44; implantation of a cardioverter-defibrillator&#44; and vascular surgery&#41;&#44; did not meet study criteria and were excluded&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">All patients were prepared for surgery using the same&#44; standard&#44; procedure&#58; on admission to the operating room&#44; the patient was placed in the supine position and heart rate&#44; blood pressure&#44; oxygen saturation and depth of anaesthesia &#40;using the bispectral &#91;BIS&#93; index&#41; were monitored&#46; Peripheral &#40;ProtectIV Plus 18 G&#41; and arterial &#40;Leadercath 3 fr&#41; lines were placed in the left arm&#44; a double-lumen blue FlexTip &#40;Arrow 7 fr&#41; central venous catheter was placed in the subclavian vein&#44; and a foley catheter &#40;Rusch Gold ch 14&#41; was placed&#46; The same general anaesthesia protocol was used in all patients&#59; non-selective intubation using a standard tube and intravenous drugs at patient-adjusted doses&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The surgical approach was the same in all cases&#46; Median sternotomy was performed to facilitate large vessels cannulation and connection to the cardiopulmonary bypass &#40;CPB&#41; pump following administration of sodium heparin 2<span class="elsevierStyleHsp" style=""></span>IU&#47;kg into the right atrium&#46; After confirming activated clotting times &#40;ACT&#41; of over 200<span class="elsevierStyleHsp" style=""></span>s&#44; the aorta was clamped and cardioplegia was induced with pharmacological agents and cold cardioplegic solution&#46; After separation from the CPB pump&#44; protamine &#40;a heparin antagonist&#41; was administered at a ratio of 1&#58;1 with heparin&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The CS was prepared and used in the same way in all patients&#46; The CS circuit was primed and purged with 3000<span class="elsevierStyleHsp" style=""></span>ml saline 0&#46;9&#37; mixed with 30&#44;000<span class="elsevierStyleHsp" style=""></span>IU of sodium heparin to prevent clotting of blood entering the machine&#46; Blood shed from the surgical field was salvaged using a double lumen Yankauer suction tip with a bulbous head and adjustable vacuum pressure of &#8722;20<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O&#46; Salvaged blood was collected in a reservoir from where it was transferred to a washing chamber for processing &#40;separating RBCs from the other blood components&#41; at an average speed of 2000<span class="elsevierStyleHsp" style=""></span>RPM&#44; depending on the program selected &#40;high quality wash&#41;&#46; After processing&#44; a bag containing only RBCs was obtained and reinfused after surgery&#46; The other blood components discarded by the CS were collected in another bag&#46; Sternal closure was performed using non-absorbable stainless steel monofilament &#40;V-40&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Sociodemographic variables were collected&#58; age&#44; sex&#44; body mass index &#40;BMI&#41;&#44; medical diagnosis &#40;aortic&#44; mitral or tricuspid valve disease and coronary arteriosclerosis&#41;&#44; and surgical intervention on arrival of the patient in the operating room&#46; All these parameters were obtained from the patient&#39;s medical history&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Haematological variables were also collected&#58; haemoglobin &#40;g&#47;dl&#41;&#44; haematocrit &#40;&#37;&#41;&#44; platelets &#40;10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#41;&#44; total proteins &#40;g&#47;dl&#41;&#44; prothrombin time &#40;PT &#91;s&#93;&#41;&#44; activated partial thromboplastin time &#40;aPTT &#91;s&#93;&#41;&#44; coagulation times &#40;ACT &#91;s&#93;&#41;&#44; international normalised ratio &#40;INR &#91;s&#93;&#41;&#44; red blood cell distribution width &#40;RDW &#91;&#37;&#93;&#41;&#44; C-reactive protein &#40;CRP &#91;mg&#47;l&#93;&#41; and D-dimer &#40;&#956;g&#47;l&#41; at 2 time points&#58; prior to reinfusion and 12<span class="elsevierStyleHsp" style=""></span>h after reinfusion&#46; These data were obtained from the results of the standard preoperative complete blood count contained in the patient&#39;s electronic medical record&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">CS variables&#58; haemoglobin &#40;gr&#47;dl&#41; haematocrit &#40;&#37;&#41; obtained from samples taken from the collection reservoir and reinfusion bag and analysed using the approved Cobas b 221 testing system installed in the operating room&#59; processing time expressed in minutes&#59; volume of blood salvaged and red blood cells obtained&#59; volume of blood washed and discarded&#46; All these variables were expressed in ml&#44; and were obtained from the digital screen of the CS machine after use&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">All data were analysed using SPSS version 22&#46;0&#46; Numerical variables were expressed as mean and standard deviation&#46; Continuous variables were tested for statistical significance using the Student&#39;s t test&#46; The non-parametric Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test was used to compare differences between 2 ordinal variables&#46; A significance level of <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 was used in all tests&#44; with a sampling error of 3&#37;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Ethical matters</span><p id="par0055" class="elsevierStylePara elsevierViewall">The study was carried out in accordance with the principles of the Declaration of Helsinki and the provisions of the Spanish Protection of Personal Data Act &#40;15&#47;1999 of December 13&#41; and its implementing regulation &#40;RD 1720&#47;2007 of December 21&#41;&#46; The study was explained in detail &#40;verbally&#41; to all patients&#46; Personal data were anonymised&#44; and patients were identified solely by a numeric code&#46; All signed informed consent forms were stored safely and were accessible only to the researcher&#46; The study was approved by the Institutional Review Board&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">Of the 789 &#40;100&#37;&#41; patients scheduled for cardiac surgery&#44; 479 &#40;60&#46;7&#37;&#41; met the inclusion criteria and were duly included&#44; and 310 &#40;39&#46;3&#37;&#41; were excluded because CS was not used for the following reasons&#58; 181 &#40;23&#37;&#41; due to pacemaker insertion&#44; 89 &#40;11&#46;3&#37;&#41; due to insertion of an implantable cardioverter defibrillator &#40;ICD&#41;&#44; and 40 &#40;5&#37;&#41; due to vascular surgery &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Patient characteristics were&#58; average age 63 years&#59; mostly men &#40;56&#46;1&#37;&#41; with mean BMI 25&#59; mostly undergoing aortic valve surgery &#40;75&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Mean CS parameters were&#58; salvaged blood volume 1910<span class="elsevierStyleHsp" style=""></span>ml &#40;minimum 101<span class="elsevierStyleHsp" style=""></span>ml&#59; maximum 2210<span class="elsevierStyleHsp" style=""></span>ml&#41;&#59; volume of RBCs obtained and reinfused 605<span class="elsevierStyleHsp" style=""></span>ml &#40;minimum 52<span class="elsevierStyleHsp" style=""></span>ml&#59; maximum 816<span class="elsevierStyleHsp" style=""></span>ml&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">With regard to haematological values&#44; a statistically significant increase in haemoglobin &#40;9&#46;5&#8211;12&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#44; haematocrit &#40;26&#8211;38&#37;&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;014&#41; CRP &#40;8&#46;5&#8211;22&#46;1<span class="elsevierStyleHsp" style=""></span>mg&#47;l&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;006&#41;&#44; and D-dimer &#40;493&#46;3&#8211;875&#46;5<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;l&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41; levels was observed after reinfusion&#44; while platelet count &#40;214&#46;2&#8211;164&#46;2<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#41; and total protein &#40;7&#46;6&#8211;5&#46;1<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#41; were lower after reinfusion&#46; The remaining values were similar before and after reinfusion with salvaged blood&#44; so the main outcome measures were statistically significant &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">The results of this study show that haematological changes occur in patients before and after reinfusion of salvaged blood&#46; The reinfusion of haemoglobin- and haematocrit-rich RBCs consequently increased the patient&#39;s own baseline haematological values during the first 12 postoperative hours&#46; The reinfusion of RBCs depletes the patient&#39;s own reserves&#44; which explains the decrease in platelet and total protein levels&#46; The increase in D-dimer and CRP levels after reinfusion raises the possibility that small quantities of fibrin may be generated &#40;formed during the resorption of a haematoma or during haemorrhage&#41;&#44; thus increasing the risk of thrombosis or blood clots&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">19</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">After analysing the different safety alerts regarding the use of CS&#44; the <span class="elsevierStyleItalic">Grupo de Estudios Multidisciplinares</span> &#40;Multidisciplinary Studies Group&#41; called for complementary studies to analyse the effect of reinfused salvaged blood on haematological values&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">20</span></a> The Group also analysed the costs and benefits of salvaged blood reinfusion in other surgeries&#44; such as obstetric&#44;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">21</span></a> gynaecological<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">22</span></a> or orthopaedic<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">23</span></a> procedures&#44; based on existing studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">2&#44;11</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Salaria et al&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">24</span></a> showed that RBCs from CS are subject to storage lesions&#46; After reinfusion&#44; blood analyses showed RBC cell membrane deformity in proportion to the volume of reinfused salvaged blood&#46; However&#44; the authors do not identify these lesions or the possible haematological abnormalities that result from such reinfusion&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">A number of invasive <span class="elsevierStyleItalic">Mycobacterium chimaera</span> infections &#40;originating in cardiopulmonary bypass pumps&#41; have been reported after open-heart surgery&#46; Collecting blood that has passed through these pumps might expose the salvaged blood to these bacteria&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">25</span></a> This has also been reported in other studies&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">26</span></a> However&#44; these studies do not determine the presence of these bacteria in CS units or the possible haematological complications that can arise in patients reinfused with salvaged blood&#46; True enough&#44; some studies describe the administration of 10<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;ml of vancomycin in the CS reservoir to eliminate any possible bacterial contamination&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">27</span></a> but they do not evaluate the haematological abnormalities that could arise in the patient before or after reinfusion of salvaged RBCs&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Gabel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">28</span></a> support the use of salvaged blood by showing that CS processing mitigated the impaired platelet aggregability typical of unprocessed wound blood&#46; However&#44; they also observed that CS processing reduced the platelet count&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">In other surgeries&#44; such as orthopaedic procedures &#40;patients with acetabular fractures&#41;&#44; CS is associated with postoperative complications&#44; and is not recommended&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">29</span></a> However&#44; in contrast to our study&#44; other authors do not describe in detail the postoperative haematological changes &#40;PT&#44; aPTT&#44; INR&#44; total proteins&#44; CRP or D-dimer&#44; among other values&#41; caused by CS&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Scientific evidence has shown that reinfusion of RBCs from CS can be harmful&#46; Marcheix et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">30</span></a> for example&#44; described a decrease in complement activation in patients undergoing coronary surgery&#44; while Sandoval et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">31</span></a> found a statistically significant increase in interleukins &#40;IL&#41; IL-1&#44; IL-2&#44; IL-4&#44; IL-6&#44; IL-8&#44; IL-10 and tumour necrosis factor in patients receiving salvaged blood&#46; However&#44; none of these studies analysed changes in blood values before and after reinfusion&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Our study has some design limitations&#44; namely&#44; the absence of a control group not receiving blood from CS&#46; This would have allowed us to compare the haematological values between the control and intervention groups&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">In this context&#44; our study has enriched scientific knowledge by identifying some of the haematological changes occurring after reinfusion of CS-processed blood&#59; we believe our findings will help improve the postoperative care of patients receiving such transfusions&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Finally&#44; our findings have both practical and investigational implications for the use of CS&#44; as they will enable clinicians to prescribe the correct treatment &#40;pharmacological&#44; blood transfusions or other procedures&#41; based on the haematological changes presented by these patients&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Time will&#44; no doubt&#44; refocus the debate following publication of these findings&#46; We hope this will encourage researchers to carry out other comparative or cohort studies to associate the use of CS with complications during the postoperative period&#44; and thus improve postoperative care and address the concerns of scientific associations and other institutions regarding the use of CS&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Based on our results&#44; we conclude that patients receiving reinfusion of CS-processed blood present increased levels of haemoglobin&#44; haematocrit&#44; CRP and D-dimer&#44; and decreased platelet count and total proteins during the postoperative period&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Ethical disclosures</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Protection of human and animal subjects</span><p id="par0140" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Confidentiality of data</span><p id="par0145" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols implemented in their place of work regarding the use of patient data in publications&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Right to privacy and informed consent</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors have obtained the informed consent of all patients and&#47;or subjects included in this manuscript&#46; The informed consent forms can be obtained from the author for correspondence&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflict of interests</span><p id="par0155" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres982050"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objective"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Material and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec949628"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres982051"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Material y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec949627"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Material and methods"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Study subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Statistical analysis"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Ethical matters"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Discussion"
        ]
        8 => array:3 [
          "identificador" => "sec0040"
          "titulo" => "Ethical disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        9 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Conflict of interests"
        ]
        10 => array:2 [
          "identificador" => "xack332728"
          "titulo" => "Acknowledgements"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2017-04-20"
    "fechaAceptado" => "2017-09-12"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec949628"
          "palabras" => array:4 [
            0 => "Cell saver"
            1 => "Haematology"
            2 => "Reinfusion"
            3 => "Cardiac"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec949627"
          "palabras" => array:4 [
            0 => "Recuperador celular"
            1 => "Hematolog&#237;a"
            2 => "Reinfusi&#243;n"
            3 => "Card&#237;aca"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">There are studies that declare blood recovered with the autotransfusion system that is potentially heparinised and mixed with other drugs&#44; can cause haematological alterations in the patient&#44; according to existing evidence&#46; The proposal was to compare the haematological values of the patients before reinfusing red blood cells from the cell saver and 12<span class="elsevierStyleHsp" style=""></span>h after reinfusion&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Observational analytical study of 479 patients who underwent cardiac surgery where the cell saver was used&#46; Haematological variables were collected before reinfusion and 12<span class="elsevierStyleHsp" style=""></span>h after reinfusion&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Statistically significant haematological values before reinfusion and 12<span class="elsevierStyleHsp" style=""></span>h after reinfusion were&#58; haemoglobin &#40;9&#46;5&#8211;12&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dL&#41;&#44; haematocrit &#40;26&#8211;38&#37;&#41;&#44; platelets &#40;214&#46;2&#8211;164&#46;2<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">3</span>&#47;&#956;L&#41;&#44; total proteins &#40;7&#46;6&#8211;5&#46;1<span class="elsevierStyleHsp" style=""></span>g&#47;dL&#41;&#44; PCR &#40;8&#46;5&#8211;22&#46;1<span class="elsevierStyleHsp" style=""></span>mg&#47;L&#41; and D-dimer &#40;493&#46;3&#8211;875&#46;5<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;L&#41; with <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">With the use of the cell saver an increase was observed of haemoglobin&#44; haematocrit&#44; PCR and D-dimer values together with a decrease in platelet and total protein numbers&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Existen estudios que declaran la sangre recuperada con el sistema de autotransfusi&#243;n que est&#225; potencialmente heparinizada y mezclada con otros f&#225;rmacos&#44; lo que puede provocar alteraciones hematol&#243;gicas en el paciente&#44; a tenor de la evidencia existente&#46; Se plante&#243; comparar los valores hematol&#243;gicos de los pacientes antes de reinfundir gl&#243;bulos rojos procedentes del recuperador celular y 12<span class="elsevierStyleHsp" style=""></span>h despu&#233;s de la reinfusi&#243;n&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio anal&#237;tico observacional en el cual se estudiaron 479<span class="elsevierStyleHsp" style=""></span>pacientes intervenidos de cirug&#237;a card&#237;aca donde se utiliz&#243; el recuperador celular&#46; Se recogieron variables hematol&#243;gicas antes de reinfundir y 12<span class="elsevierStyleHsp" style=""></span>h despu&#233;s de haber sido reinfundidos&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Los valores hematol&#243;gicos estad&#237;sticamente significativos antes de la reinfusi&#243;n y 12<span class="elsevierStyleHsp" style=""></span>h despu&#233;s de la reinfusi&#243;n fueron&#58; hemoglobina &#40;9&#44;5 a 12&#44;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#41;&#44; hematocrito &#40;26 a 38&#37;&#41;&#44; plaquetas &#40;214&#44;2 a 164&#44;2<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#41;&#44; prote&#237;nas totales &#40;7&#44;6 a 5&#44;1<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#41;&#44; PCR &#40;8&#44;5 a 22&#44;1<span class="elsevierStyleHsp" style=""></span>mg&#47;l&#41; y d&#237;mero-D &#40;493&#44;3 a 875&#44;5<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;l&#41;&#44; con p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Con el uso del recuperador celular se observ&#243; un aumento de los valores de hemoglobina&#44; hematocrito&#44; PCR y d&#237;mero-D junto con la disminuci&#243;n de cifras de plaquetas y prote&#237;nas totales&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as&#58; Luque-Oliveros M&#46; Alteraciones hematol&#243;gicas en el paciente card&#237;aco tras uso de un sistema de autotransfusi&#243;n&#46; Rev Esp Anestesiol Reanim&#46; 2018&#59;65&#58;74&#8211;80&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1881
            "Ancho" => 2833
            "Tamanyo" => 198084
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flowchart&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">BMI&#58; body mass index&#59; CD-Sx&#58; clinical diagnosis-surgical intervention&#59; Fr &#40;&#37;&#41;&#58; frequency &#40;percentage&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean Fr &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Standard deviation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Minimum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Maximum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Gender</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">269 &#40;56&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Women&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">210 &#40;43&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>18&#8211;29 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>30&#8211;45 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>46&#8211;65 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">421 &#40;87&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;65 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45 &#40;9&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">BMI</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;18&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>18&#46;5&#8211;24&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">127 &#40;26&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>25&#8211;29&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">331 &#40;69&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">DC-Sx</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Aortic valve&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">364 &#40;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mitral valve&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Tricuspid valve&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Coronary art&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1662954.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">BMI&#58; &#60;18&#46;5 &#40;low weight&#41;&#59; 18&#46;5&#8211;24&#46;9 &#40;normal&#41;&#59; 25&#8211;29&#46;9 &#40;overweight&#41;&#44; and &#62;30 &#40;obese&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Characteristics of study subjects&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Hb&#58; haemoglobin&#59; Htc&#58; haematocrit&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Standard deviation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Minimum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Maximum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">In reservoir</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hb &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Htc &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">In reinfusion bag</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hb &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Htc &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Volumes</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Waste &#40;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5647&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1597&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Washed &#40;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3363&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1016&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Processing</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Time &#40;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1662953.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Mean values in CS blood&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Quantitative variables are expressed as mean and standard deviation&#44; unless otherwise indicated&#46;</p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Values in bold indicate significant differences&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46;</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">ACT&#58; activated clotting time&#59; aPTT&#58; activated partial thromboplastin time&#59; CRP&#58; C-reactive protein&#59; Hb&#58; haemoglobin&#59; Htc&#58; haematocrit&#59; INR&#58; international normalised ratio&#59; PT&#58; prothrombin time&#59; RDW&#58; red blood cell distribution width&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Parameters&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Before reinfusion &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>479&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Standard deviation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">12<span class="elsevierStyleHsp" style=""></span>h after reinfusion &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>479&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Standard deviation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">U</span> Mann&#8211;Whitney Student&#39;s <span class="elsevierStyleItalic">t</span> test<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hb&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;008<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Htc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Platelets&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">214&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">164&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total protein&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;717&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">aPTT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ACT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">200&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">85&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">191&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">INR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">RDW&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;124&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CRP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">D-Dimer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">493&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">174&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">875&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">268&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1662955.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Student&#39;s <span class="elsevierStyleItalic">t</span> test&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Mean haematological values in study patients&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:31 [
            0 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2011 ACCF&#47;AHA guideline for coronary artery bypass graft surgery&#58; executive summary"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "American College of Cardiology Foundation&#47;American Heart Association Task Force on Practice Guidelines"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46;D&#46; Hillis"
                            1 => "P&#46; Smith"
                            2 => "P&#46;K&#46; Anderson"
                            3 => "J&#46;L&#46; Bittl"
                            4 => "J&#46;A&#46; Briges"
                            5 => "C&#46; Byrne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIR.0b013e31823b5fee"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2011"
                        "volumen" => "124"
                        "paginaInicial" => "2610"
                        "paginaFinal" => "2642"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22064600"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists Blood Conservation Clinical Practice Guidelines"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46;A&#46; Ferraris"
                            1 => "J&#46; Brown"
                            2 => "G&#46; Despotis"
                            3 => "J&#46; Hammon"
                            4 => "T&#46; Brett"
                            5 => "S&#46; Saha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.athoracsur.2010.11.078"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2011"
                        "volumen" => "91"
                        "paginaInicial" => "944"
                        "paginaFinal" => "982"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21353044"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Safety of preoperative blood donation &#40;for autotransfusion&#41; for cardiac surgery patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "E&#46; Santoni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Tranfusion"
                        "fecha" => "2012"
                        "volumen" => "33"
                        "paginaInicial" => "91"
                        "paginaFinal" => "95"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pretransfusion comparison of dialyser-based hemoconcentrator with cell saver system for perioperative cell salvage"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Garp"
                            1 => "A&#46; Malhotra"
                            2 => "M&#46; Desai"
                            3 => "P&#46; Sharma"
                            4 => "A&#46;K&#46; Bishnoi"
                            5 => "P&#46; Tripathi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Innovations &#40;Phila&#41;"
                        "fecha" => "2015"
                        "volumen" => "10"
                        "paginaInicial" => "334"
                        "paginaFinal" => "341"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Implementation of an obstetric cell salvage service in a tertiary women&#39;s hospital"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46; Lew"
                            1 => "S&#46; Tagore"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.11622/smedj.2015121"
                      "Revista" => array:6 [
                        "tituloSerie" => "Singapore Med J"
                        "fecha" => "2015"
                        "volumen" => "56"
                        "paginaInicial" => "445"
                        "paginaFinal" => "449"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26311910"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cell salvage during coronary artery bypass surgery and allogenic blood exposure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Al-Mandhari"
                            1 => "M&#46;M&#46; Maddali"
                            2 => "M&#46;J&#46; Al-Brahrani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0218492315592788"
                      "Revista" => array:7 [
                        "tituloSerie" => "Asian Cardiovasc Thorac Ann"
                        "fecha" => "2015"
                        "volumen" => "23"
                        "paginaInicial" => "913"
                        "paginaFinal" => "916"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26113735"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0195670116000888"
                          "estado" => "S300"
                          "issn" => "01956701"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of three blood-processing techniques during and after cardiopulmonary bypass"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Sutton"
                            1 => "J&#46; Kratz"
                            2 => "F&#46; Spinale"
                            3 => "F&#46; Crawford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "1993"
                        "volumen" => "56"
                        "paginaInicial" => "938"
                        "paginaFinal" => "943"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8215672"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of severe perioperative bleeding&#58; guidelines from the European Society of Anaesthesiology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;A&#46; Kozek-Langenecker"
                            1 => "A&#46; Afshari"
                            2 => "P&#46; Albaladejo"
                            3 => "C&#46; Aldecoa"
                            4 => "E&#46; de Robertis"
                            5 => "D&#46;C&#46; Filipescu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/EJA.0b013e32835f4d5b"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Anaesthesiol"
                        "fecha" => "2013"
                        "volumen" => "30"
                        "paginaInicial" => "270"
                        "paginaFinal" => "382"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23656742"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sangre y cirug&#237;a&#46; Estrategia de ahorro en cirug&#237;a card&#237;aca"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Fl&#243;rez"
                            1 => "L&#46; Prieto"
                            2 => "L&#46; Maroto"
                            3 => "J&#46; Bustamante"
                            4 => "T&#46; Cubero"
                            5 => "M&#46; Fern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Esp Investig Quir"
                        "fecha" => "2011"
                        "volumen" => "14"
                        "paginaInicial" => "89"
                        "paginaFinal" => "114"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Argatroban for anticoagulation of a blood salvage system&#8212;an ex vivo study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Beiderlinden"
                            1 => "C&#46; Brau"
                            2 => "S&#46; di Grazia"
                            3 => "M&#46; Wehmeier"
                            4 => "T&#46;A&#46; Treschan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12871-016-0204-3"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Anesthesiol"
                        "fecha" => "2016"
                        "volumen" => "16"
                        "paginaInicial" => "37"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27418211"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thrombocytopenia in critically ill patients&#58; a review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Chaari"
                            1 => "F&#46; Medhioub"
                            2 => "M&#46; Samet"
                            3 => "K&#46; Chtara"
                            4 => "R&#46; Allala"
                            5 => "H&#46; Dammak"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Trends Anaesth Crit Care"
                        "fecha" => "2011"
                        "volumen" => "1"
                        "paginaInicial" => "199"
                        "paginaFinal" => "202"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of mechanical cell savage on red blood cell aggregation&#44; deformability&#44; and 2&#44;3-diphosphoglycerate in patients undergoing cardiac surgery with cardiopulmonary bypass"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46;J&#46; Gu"
                            1 => "W&#46;J&#46; Vermeijden"
                            2 => "A&#46;J&#46; de Vries"
                            3 => "J&#46;A&#46; Hagenaars"
                            4 => "R&#46; Graaff"
                            5 => "W&#46; van Oeveren"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.athoracsur.2008.07.052"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2008"
                        "volumen" => "86"
                        "paginaInicial" => "1570"
                        "paginaFinal" => "1575"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19049752"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Morbidity of bleeding after cardiac surgery&#58; is it blood transfusion&#44; reoperation for bleeding&#44; or both&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Vivacqua"
                            1 => "C&#46;G&#46; Koch"
                            2 => "A&#46;M&#46; Yousuf"
                            3 => "E&#46;R&#46; Nowicki"
                            4 => "P&#46;L&#46; Houghtaling"
                            5 => "E&#46;H&#46; Blackstone"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.athoracsur.2011.03.105"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2011"
                        "volumen" => "91"
                        "paginaInicial" => "1780"
                        "paginaFinal" => "1790"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21619974"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Discriminatory power of the intraoperative cell salvage use in the prediction of platelet and plasma transfusion in patients undergoing cardiac surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Al-Khabori"
                            1 => "A&#46;Z&#46; Al-Riyami"
                            2 => "B&#46; Baskaran"
                            3 => "M&#46; Siddiqi"
                            4 => "H&#46; Al-Sabti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.transci.2015.03.019"
                      "Revista" => array:6 [
                        "tituloSerie" => "Transfus Apher Sci"
                        "fecha" => "2015"
                        "volumen" => "53"
                        "paginaInicial" => "208"
                        "paginaFinal" => "212"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25863410"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Changes in cerebral oxygenation during transfusion therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Hakin"
                            1 => "D&#46; Tumin"
                            2 => "D&#46;P&#46; Martin"
                            3 => "W&#46; Samora"
                            4 => "A&#46;C&#46; Beebe"
                            5 => "J&#46;E&#46; Klamar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Extra Corpor Technol"
                        "fecha" => "2016"
                        "volumen" => "48"
                        "paginaInicial" => "173"
                        "paginaFinal" => "178"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27994257"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reinfusate heparin concentrations produced by two autotransfusion systems"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "W&#46;F&#46; Buys"
                            1 => "M&#46; Buys"
                            2 => "A&#46;L&#46; Levin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.jvca.2016.06.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cardiothorac Vasc Anesth"
                        "fecha" => "2017"
                        "volumen" => "31"
                        "paginaInicial" => "90"
                        "paginaFinal" => "98"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27591910"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics and quality of intra-operative cell savage in paediatric scoliosis surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Perez"
                            1 => "E&#46; Gredilla"
                            2 => "J&#46; de Vicente"
                            3 => "R&#46; Navarro"
                            4 => "F&#46; Gilsanz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.redar.2015.05.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Anestesiol Reanim"
                        "fecha" => "2016"
                        "volumen" => "63"
                        "paginaInicial" => "78"
                        "paginaFinal" => "83"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26162899"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influencia del recuperador celular en la respuesta inflamatoria y en las necesidades transfusionales en cirug&#237;a card&#237;aca&#58; estudio prospectivo aleatorizado"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46; Reyes"
                            1 => "M&#46;A&#46; Prieto"
                            2 => "J&#46; Bustamante"
                            3 => "P&#46; &#193;lvarez"
                            4 => "S&#46; Badia"
                            5 => "A&#46; Sarraj"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cir Cardiovasc"
                        "fecha" => "2010"
                        "volumen" => "17"
                        "numero" => "Suppl&#46; 1"
                        "paginaInicial" => "37"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Papel de los d&#237;meros D en la enfermedad venosa tromboemb&#243;lica &#40;EVT&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46; Sitbon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Bioqu&#237;m Clin Latinoam"
                        "fecha" => "2010"
                        "volumen" => "44"
                        "paginaInicial" => "101"
                        "paginaFinal" => "108"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Foro de debate&#58; seguridad de las alternativas a la transfusi&#243;n alog&#233;nica en el paciente quir&#250;rgico y&#47;o cr&#237;tico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Mu&#241;oz"
                            1 => "E&#46; Bisbe"
                            2 => "E&#46; Basora"
                            3 => "J&#46;A&#46; Garc&#237;a"
                            4 => "A&#46; G&#243;mez"
                            5 => "S&#46;R&#46; Leal-Noval"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2015.05.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2015"
                        "volumen" => "39"
                        "paginaInicial" => "552"
                        "paginaFinal" => "562"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26183121"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The economic benefits of cell salvage in obstetric haemorrhage"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Brearton"
                            1 => "A&#46; Bhalla"
                            2 => "S&#46; Mallaiah"
                            3 => "P&#46; Barclay"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijoa.2012.05.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Obstet Anesth"
                        "fecha" => "2012"
                        "volumen" => "21"
                        "paginaInicial" => "329"
                        "paginaFinal" => "333"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22858041"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The use of cell salvage in women undergoing cesarean hysterectomy for abnormal placentation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Elagamy"
                            1 => "A&#46; Abdelaziz"
                            2 => "M&#46; Ellaithy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijoa.2013.05.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Obstet Anesth"
                        "fecha" => "2013"
                        "volumen" => "22"
                        "paginaInicial" => "289"
                        "paginaFinal" => "293"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23958277"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Indications and outcomes of cell saver in adolescent scoliosis correction surgery&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "N&#46; Stone"
                            1 => "V&#46; Sardana"
                            2 => "P&#46; Missiuna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Spine &#40;Phila Pa 1976&#41;"
                        "fecha" => "2017"
                        "volumen" => "42"
                        "paginaInicial" => "E363"
                        "paginaFinal" => "E370"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impaired red blood cell deformability after transfusion of stored allogenic blood but not autologous salvaged blood in cardiac surgery patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "O&#46;N&#46; Salaria"
                            1 => "V&#46;M&#46; Barodka"
                            2 => "C&#46;W&#46; Hogue"
                            3 => "D&#46;E&#46; Bekowitz"
                            4 => "P&#46;M&#46; Ness"
                            5 => "J&#46;O&#46; Wasey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1213/ANE.0000000000000227"
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "2014"
                        "volumen" => "118"
                        "paginaInicial" => "1179"
                        "paginaFinal" => "1187"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24806142"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reemergence of <span class="elsevierStyleItalic">Mycobacterium chimaera</span> in heater-cooler units despite intensified cleaning and disinfection protocol"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Schreiber"
                            1 => "S&#46; Kuster"
                            2 => "B&#46; Hasse"
                            3 => "C&#46; Bayard"
                            4 => "C&#46; Ruegg"
                            5 => "P&#46; Kohler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3201/eid2210.160925"
                      "Revista" => array:6 [
                        "tituloSerie" => "Emerg Infect Dis"
                        "fecha" => "2016"
                        "volumen" => "22"
                        "paginaInicial" => "1830"
                        "paginaFinal" => "1833"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27649345"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Notes from the field&#58; <span class="elsevierStyleItalic">Mycobacterium chimaera</span> contamination of heater cooler devices used in cardiac surgery-United States"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Perkins"
                            1 => "A&#46; Lawsin"
                            2 => "N&#46; Hasan"
                            3 => "M&#46; Strong"
                            4 => "A&#46; Halpin"
                            5 => "R&#46; Rodger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.15585/mmwr.mm6540a6"
                      "Revista" => array:6 [
                        "tituloSerie" => "MMWR Morb Mortal Wkly Rep"
                        "fecha" => "2016"
                        "volumen" => "65"
                        "paginaInicial" => "1117"
                        "paginaFinal" => "1118"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27740609"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vancomycin added to the wash solution of the cell-saver&#46; Effect on bacterial contamination"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Perez"
                            1 => "E&#46; Gredilla"
                            2 => "J&#46; de Vicente"
                            3 => "R&#46; Navaroo"
                            4 => "F&#46; Gilsanz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.redar.2016.10.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Anestesiol Reanim"
                        "fecha" => "2017"
                        "volumen" => "64"
                        "paginaInicial" => "185"
                        "paginaFinal" => "191"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28094033"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cell saver processing mitigates the negative effects of wound blood on platelet function"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Gabel"
                            1 => "C&#46;J&#46; Malm"
                            2 => "V&#46; Radulovic"
                            3 => "C&#46; Shams Hakimi"
                            4 => "M&#46; Westerberg"
                            5 => "A&#46; Jeppsson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Anesthesiol Scand"
                        "fecha" => "2016"
                        "volumen" => "60"
                        "paginaInicial" => "901"
                        "paginaFinal" => "909"
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673600028142"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cell saver use in acetabular surgery&#58; does approach matter&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Firoozabi"
                            1 => "A&#46; Swenson"
                            2 => "C&#46; Kleweno"
                            3 => "M&#46;C&#46; Routt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/BOT.0000000000000292"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Orthop Trauma"
                        "fecha" => "2015"
                        "volumen" => "29"
                        "paginaInicial" => "349"
                        "paginaFinal" => "353"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25635358"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of pericardial blood processing on postoperative inflammation and the complement pathways"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Marcheix"
                            1 => "M&#46; Carrier"
                            2 => "C&#46; Martel"
                            3 => "M&#46; Cossette"
                            4 => "M&#46; Pellerin"
                            5 => "D&#46; Bouchard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.athoracsur.2007.08.050"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2008"
                        "volumen" => "85"
                        "paginaInicial" => "530"
                        "paginaFinal" => "535"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18222258"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A cytokine analysis of the effect of cell saver on blood in coronary bypass surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Sandoval"
                            1 => "S&#46; Alrawi"
                            2 => "M&#46; Samee"
                            3 => "M&#46; Same"
                            4 => "R&#46; Satheesan"
                            5 => "R&#46; Raju"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Heart Surg Forum"
                        "fecha" => "2001"
                        "volumen" => "4"
                        "paginaInicial" => "113"
                        "paginaFinal" => "117"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11544618"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack332728"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0160" class="elsevierStylePara elsevierViewall">We would like to thank Dr&#46; Polo for his statistical analysis and advice&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23411929/0000006500000002/v1_201802090832/S2341192917302044/v1_201802090832/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006500000002/v1_201802090832/S2341192917302044/v1_201802090832/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192917302044?idApp=UINPBA00004N"
]