Evaluation Of Blood Processed By Cell Saver In Pediatric Scoliosis

Evaluation Of Blood Processed By Cell Saver In Pediatric Scoliosis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article Evaluation Of Blood Processed By Cell Saver In Pediatric Scoliosis Elena García, Pilar Del Rey, Ernesto Martínez This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-22710/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 03 Jun, 2020 Read the published version in Journal of Medical Research and Health Sciences → Version 1 posted You are reading this latest preprint version Abstract Introduction We study the hematological and microbiological characteristics from the autologous blood processed through the intraoperative cell saver used in our centre (Orthopat®) during the correction of pediatric scoliosis, which is known to be a potentially bleeding surgery. Material and methods Descriptive analysis of 31 patients undergoing pediatric scoliosis surgery. All of them received blood processed by cell saver intraoperatively. The variables collected were: demographic data, volume of the autogenous red blood cell (RBC) concentrate, blood count, biochemistry, blood culture, preoperative and postoperative blood tests of the patients, incidence of fever during reinfusion of RBC concentrate, postoperative surgical site infections and length of hospital stay. Results Average volume obtained 288.06ml (sd 154.68). Hematocrit 70.38% (ds 10.03) in accordance with cell-saver commercial data (75%). Of the blood samples obtained, 42.86% had blood cultures that were positive for aerobes and 48.28% for anaerobes. The relation between postoperative infections and contamination of blood concentrates was not statistically significant. When comparing the pre-surgery and post-surgery analytical samples, statistically significant differences (p <0.05) were found in the following: hemoglobin and hematocrit decreased in the postoperative period, while coagulation parameters show a tendency to coagulopathy. Conclusion Our cell saver obtains RBC concentrates with a percentage of hematocrit in agreement with available information. The reinfusion of them is safe from an infectious and biochemical point of view, but its immunological implications are not clear. This surgery continues to result in a significant loss of blood. Measures taken to avoid allogenic transfusions remain necessary and should be enhanced. Pediatrics autologous-transfusion bloodless medicine cell-saver inmunomodulation pediatric-scoliosis blood test. Background The use of blood products transfusion has changed dramatically during the last decades. Liberal transfusion triggers have been replaced by more restrictive transfusion guidelines. This change results from an increased awareness of existing relations between allogenic transfusions and adverse reactions, and of the need to avoid overusing blood bank resources. For these reasons, new blood saving techniques have emerged in recent decades. For instance, the collection of blood from the surgical field by a device capable of processing it, such as the cell saver, so as to obtain reinfusion bags with high hematocrit percentages. Such autologous transfusion is considered to be safe as far as infection transmission and the generation of immunological problems are concerned. Futhermore, it reduces the risk of receiving allogeneic transfusions in surgeries with moderate-high bleeding, such as scoliosis surgery. Its use in pediatric surgeries is still a controversial issue, while research on its efficacy and the quality of the blood obtained in these interventions is very scarce 1,2 . The cell saver available for the study is the Orthopat ®, with a pediatric hood. Two hundred mililitres of products from the surgical field are necessary to start processing blood. According to the commercial data sheet, the material available for reinfusion has around 70% hematocrit. It is expected to be free of activated coagulation factors, anticoagulant, leukocytes, platelets, cell stroma, free hemoglobin, intracellular enzymes and potassium. However, the effectiveness of the red cell washing process is not yet fully clear, as other blood components could be found. The product to be reinfused might be affected by bacterial contamination at different stages of the process. The results of M. Muñoz et al. 3 on experimental models with cell saver OrthoPAT® show that 70-95% of the content of leukocytes, platelets, cytokines and potassium is eliminated, while 80% of red blood cells is preserved. In this work, we study the hematological and microbiological characteristics from the autologous blood processed through the intraoperative cell saver used in our centre (Orthopat®) during the correction of pediatric scoliosis, which is known to be a potentially bleeding surgery. Regarding the hematological study, we test the effectiveness of the cell saver for obtaining high concentrations of functioning red blood cells, which according to the commercial data for adult patients should be 70%. Furthermore, we evaluate the hemolysis index of the blood samples as well as the possible analytical parameters derived from the red blood cell rupture, in cases where their measurement is technically possible. In recent decades there have been great advances in the management of surgical bleeding, which has markedly decreased. We nonetheless compare pre- and post-operative blood tests of patients after reinfusion in order to check whether differences continue to be significant with the available blood saving methods. On the other hand, we determine the microbiological characteristics of the blood obtained by the cell saver (Orthopat®). The appearance of fever after the reinfusion of the processed blood, as well as possible surgical site infections (SSI) during the postoperative one-month follow-up period, are monitored and their relation to positive blood cultures is studied. Methods This is a prospective observational study of 31 patients undergoing surgery for pediatric scoliosis. The main aim is to determine the effectiveness of the intraoperative Orthopat® cell saver with a pediatric hood by analyzing the hematological and microbiological characteristics of the obtained blood. The study was approved by the Ethics Committee of Niño Jesús Children’s University Hospital in February 2019. The data collection began immediately after the approval, and continued until November 2019. All patients included in the study suffered from pediatric scoliosis, and underwent posterior dorsal fusion surgery, during which the intraoperative cell saver was used. The parents/legal tutors of all participants signed a prior informed consent, as also did the patients themselves if they were over 12 years old. Patients for which the use of the cell saver was contraindicated (oncological patients, presence of infection...) were excluded from the study. Some cases were discarded due to loss of blood samples, inability to monitor infections during follow-up and cancelled surgeries. The patients were anesthesized folllowing the general anesthetic method of the Anesthesiology Department of our center. Perfusion of 10 mg / kg / h of tranexamic acid with an initial bolus of 15-20 mg / kg and preoperative antibiotic prophylaxis with 30 mg / kg up to 2g of cefazolin were administered. The blood was vacuumed from the surgical field with a negative pressure of less than 150 mmHg. It was subsequently mixed with heparinized physiological serum (30U / ml) to be stored in the cell saver reservoir until the centrifuge hood was filled with 200ml. Then the blood began to be processed at a speed of 8000 rpm and was finally washed with 500 ml of physiological serum to obtain the red blood cell concentrates. The variables considered in the study were patient age, weight, volemia, volume of blood from the cell saver, type of scoliosis (idiopathic, neuromuscular, associated with syndromes or hemivertebrae), and hematocrit, hemoglobin, platelets, leukocytes and basic biochemistry of the patient's preoperative and postoperative blood tests. It is important to mention that the postoperative blood sample was taken upon arrival of the patient to the Postoperative Recovery Unit after the autologous blood was transfused in the operating room. From the autologous blood we analyzed: Hematocrit, hemoglobin, platelets, leukocytes and ions, as well as blood cultures and hemolysis index, which is a colorimetric test for semiquantitative determination of hemolysis in human serum and plasma in Beckman Coulter AU analyzers®. Patient samples are diluted in the lithium hydride reagent and the absorbency is measured in 6 wavelengths. If a sample has one or more chromogens in a potentially interfering concentration, the corresponding indicators will be generated and communicated with the results of the analyzes performed on that sample. These indicators characterize the type of chromatic substance (hemoglobin) and the approximate concentration of the interference by concentration sections. The samples were taken at the time of reinfusion of the obtained blood to the patient with the greatest possible asepsis. The appearance of fever (> 38 o C) was monitored during the reinfusion of autologous blood. Moreover, days of hospital stay after surgery and surgical site infection (SSI) during a follow-up period of one month were recorded. For them, the most widely used definition of SSI has been provided by CDC 4 . According to it, SSIs are classified by depth and tissue spaces involved. The statistical analysis of the quantitative variables is given in terms of means, medians, standard deviations, minimum and maximum values. Qualitative variables are expressed as absolute frequencies and percentages. The mean values of pre and postoperative blood tests were compared with the Wilcoxon test. To establish the relationship between two quantitative variables, Pearson's correlation coefficient was used. All tests have been considered significant Results The demographic results and the volume obtained after blood processing are shown in Table 1. Regarding the sex of the patients 23 (74.19%) of them were girls and 8 (25.8%) boys. The type of surgery is shown in Table 2, observing a majority of scoliosis of idiopathic origin. Table 3 shows the hematological characteristics of the blood obtained from the cell saver. The hemolysis index is 5.48 (ds 1.73), its maximum value is 6. The average volume recovered of red blood cells is 288.06 ml (ds 154.68) with a minimum value of 50 ml and a maximum of 700 ml. The correlation between the volume processed and the hematocrit of the recovered blood: Pearson, r = 0.4426; p = 0.0126. Therefore, the greater the volume of blood recovered, the greater hematocrit is obtained in the processed red blood cell concentrate. Regarding the possible predictors of the volume recovered, we found only a relationship in the preoperative hematocrit: Pearson 0.42, p 0.02. According to the statistical regression model, the coefficient is 7.02 (p <0.001, 95% CI 5.69-8.35). This indicates that an increase of 1% in preoperative hematocrit predicts 7.02 ml more in red blood cells concentrates obteined through the cell saver. Microbiological characteristics of recovered autologous blood: The blood culture of the blood from the cell saver was positive in 12 cases (42.86%) of a total of 28 samples analyzed since three did not reach the microbiology laboratory. The types of bacteria found are shown in Tables 4 (aerobic germs) and 5 (anaerobic germs). All correspond with non-pathogenic bacteria from cutaneous flora. Clarify that there are species that appear in both tables since it can be an aerobic or anaerobic facultative bacteria. Any patient had fever during the infusiono f autologous blood. Four of them (12.90%) presented infectious complications in the first postoperative month. All cases were infection associated with surgical wound, just one of them required emergency surgery. Only two patients with infectious complications presented positive blood culture in the blood from cell saver. Chi-square does not show statistical significance to relate infectious complications with contamination of blood bags (p> 0.05). In the comparative study of the analytical samples of the pre-surgery and post-surgery patients, significant differences were found (p <0.05) in the value of: Hemoglobin, hematocrit, with both decrease in the postoperative period, prothrombin time, INR, time of cephalin, fibrinogen, with a decrease in the postoperative period and tendency to coagulopathy. All analytical parameters are shown in table 6. Discussion Our main objective has been to analyze the characteristics of the blood processed by the cell saver in pediatric scoliosis surgery. It is a blood saving technique which is increasingly used in major orthopedic surgery to avoid risks of allogeneic transfusions, such as transmission of viral diseases, risks associated with the storage of blood bags, blood group identification errors and potential decrease of immunomodulation5,6. It constitutes one aspect of the multidisciplinary approach to "patient blood management" 7,8, together with preoperative optimization, administration of tranexamic acid, ensuring a careful surgical technique with hemostasis, posterior surgical approach and lower transfusion triggers9. Our results reveal that the percentage of hematocrit obtained, which is 70.38%, is similar to that described by the technical data provided by OrthoPat® for adult patients, namely, 75%. In agreement with previous studies 10-12, the blood from the cell saver presents much higher levels of hematocrit than patient blood (30-45%) and also higher than that present in red blood cell concentrates from donors (50-65%), which is quite variable. However, leukocytes are not completely eliminated from our sample, in fact their quantity is similar to the levels found in patient postoperative analysis. Several studies13,14 have further analyzed the presence of different types of white cells and inflammatory molecules in the collected blood and their relationship with postoperative infection or days of admission. Nevertheless, no relationship or differences have been established. What seems to be clearer is the lower immunomodulatory response of autologous blood with respect to allogeneic blood transfusion15. Immunomodulation seems to be especially important in cancer patients. The use of cell saver in these cases is still controversial because of the risk of cancer cell spreading. On the other hand, the transfusion of autologous blood would reduce the risk of immunosuppression caused by allogeneic blood transfusion16,17. There is no agreement on potential effects of the presence of leukocytes in the processed blood. Special filters for their elimination increase the cost and affect the flow conditions during retransfusion, resulting in the activation of the complement system. In the case of immunosuppressed or cancer patients, leucodepletion of these concentrates could be considered for safety reasons during major orthopedic surgery18,19. The amount of platelets in autologous blood is, despite its great variability, consistently smaller than that found in pre and postoperative blood samples of the patient. These platelets levels are consistent with previous studies20,21. They suggest that the processing of platelets by the cell saver is more efficient than in the case of leukocytes. According to M. Muñoz et al.3, the processing of platelets in a postoperative recovery model with OrthoPAT® would in fact reach 88%. The importance of reinfusion of processed platelets is not clear, but it may not be functional due to the discontinuous centrifugation of this device. The hemolysis index is close to the maximum, which indicates that in the blood from the cell saver there is a high level of red blood cell breakdown. In experimental models of processed blood3 the concentration of free hemoglobin in plasma was reduced by 96% with the OrthoPAT® cell saver. As for the ions, potassium deserves special attention since a rapid reinfusion of high levels can have serious consequences. Its elimination in experimental models is around 97%3. None of our patients showed ECG abnormalities or significantly increased concentrations of this ion in the subsequent gasometric controls, despite the fact that some cases presented high concentrations of around 8 mEq x l-1. Nevertheless, the total amount of potassium in the autologous blood transfused to the patient is unlikely to be harmful. The levels of sodium and chlorine that ensure homeostasis for cell preservation are found to be similar to those in the patient blood. The volume of red blood cells from the cell saver is directly related to the hematocrit thereof. The minimum volume obtained is 50ml, which corresponds to a 17 kg patient undergoing neuromuscular scoliosis. For this type of patients, with weights less than 25 kg, it might be advisable to process blood with continuous processing devices, in order to obtain the largest possible reinfusible volumes and increased hematocrit concentrations22,23. According to the microbiological analysis of the samples of autologous blood, despite surgical asepsis and antibiotic prophylaxis, it is inevitable that bacterial contamination will appear in almost half of the cases (42.86%). These data are consistent with previous publications24-29 in which the contamination exceeds 40%. However, the reinfusion of this contaminated blood did not cause a higher incidence of fever or SSI, in agreement with the findings of the previously mentioned studies. As the isolated bacteria come from skin and environmental flora, no pathogenic germ has been found, which indicates good asepsis procedures and correct antibiotic prophylaxis of our patients. Many factors may be responsible for contamination of the blood processed, including a prolonged exposure of a wide surgical field, which is characteristic of scoliosis surgery, complex and multiple instrumentation, many professionals working in the surgical field, including the replacement of team members, as well as multiple manipulations of vascular access and fluid administration among others. Concerning immunocompromised patients, the use of a cell saver could contribute to the development of infections. To prevent this risk, adding antibiotics to the samples of processed blood in addition to applying leucodeplection should be considered as additional measures30,31. Another very different case is the immunocompetent patient, as are the majority of patients undergoing pediatric scoliosis. With careful aseptic techniques, adequate antibiotic prophylaxis and not exceeding the storage time of the blood concentrates (6 hours at room temperature or refrigerated at 4 °C for 24 hours), it continues to be a safe technique. The ranges of SSI in pediatric scoliosis can vary from 0.5% to more than 25% depending mainly on whether or not of the scoliosis is of neuromuscular origin32,33. The latter consitutes a risk factor, together with the length fo the stay, surgical instrumentation, the surgical intervention of the sacrum, the incorrect administration of antibiotic prophylaxis or the persistence of postoperative spine curvature34. Pediatric scoliosis surgery remains one of the surgeries with the highest bleeding rates35. In the present study, analytical differences between the preoperative and the immediate postoperative period have been observed. The implication is that one should continue applying and introducing new blood-saving measures. The analysis of preoperative hemoglobin revealed that 25% of the patients had a value of less than 13 g / dl, with a minimum of 10.4 g / According to this results, there are patients (<25%) with preoperative hemoglobin around or below the limit to be considered anemic. Following the multidisciplinary approach of “Patient Blood Management”, preoperative anemia should be optimized to reduce days of stay and perioperative transfusions 36-38. One of the goals of our center in this regard is that no anemic patient without prior optimization should undergo such surgery. As the associated blood loss is considerable, and it is a programmed surgery, its date could be delayed until the patient's condition improves. In addition, we observe how the preoperative hematocrit is directly related to the volume of autologus blood obtained. Our results show that scoliosis surgery continues to cause coagulopathy and a decrease in hemoglobin level (pre-surgery 13.68 g / dl, post-surgery 10.90 g / dl). To prevent such undesired effects, it is necessary to reduce bleeding by means of pharmacological agents (tranexamic acid), maintenance of low arterial pressure, hemodilution with fluid therapy, intraoperative techniques applied by surgeons to improve hemostasis, the use of cell saver and restrictive transfusion triggers to contribute to the reduction of transfusion ratios. These measures are reviewed and carried out according to the latest guidelines on blood management in pediatric scoliosis surgery39,40. The main limitation of our study is the small sample size. To obtain stronger results, it would be necessary to expand it. Moreover, it is a heterogeneous group of patients in terms of weight and origin of their scoliosis, among other factors. For instance, neuromuscular scoliosis is associated in most cases with increased morbidity and a higher risk of bleeding. In addition, other influential factors in bleeding such as the number of fusion levels or Cobb angle are not considered. We should also stress that this is a prospective study conducted in a single center. From our results we conclude that, in the pediatric patient, the cell saver used in this study obtains red blood cell concentrates with a percentage of hematocrit which is in agreement with commercial information. The reinfusion of this product seems safe from an infectious and biochemical point of view. Its implications at the immunological level are not fully clarified either in the previous literature or in our study. Broader studies that are specifically focused on this last aspect would be helpful in this regard. Conclusions Pediatric spinal fusion has a specific set of risk factors for transfusion and different perioperative requirements. A deeper knowledge of blood management techniques is improving surgical planning, as well as limiting the risks associated with transfusion, maintaining hemostasis and optimizing results in these patients. This surgery still entails an important loss of blood with repercussions for the early recovery of patients. Blood saving measures taken by the surgical team are necessary. Improving outcomes, including the reduction of perioperative risks, depends critically on them. List Of Abbreviations Sd – standard deviation RBC – red blood cell SSI – surgical site infection CDC – Centers for disease Control and Prevention INR – International Normalized Ratio Declarations Ethics approval and consent to participate The parents / guardians of the participants were asked to sign an informed consent document once they had been informed verbally and through an information sheet to parents / guardians and had been able to express and solve any doubts regarding their participation in the present study. This study is approved by the Ethics comitted of our Hospital: CEIm Hospital Infantil Universitario Niño Jesús; which is officially listed by the Ministery of our country: https://www.aemps.gob.es/investigacionClinica/medicamentos/docs/listado-comites-investigacion-clinica.pdf Consent for publication Not aplicable, there is not individual data. Availability of data and material The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding No sources of financial assistance or potential conflicts of interest. Details of authors' contributions: Elena García, EG: Study design, patient recruitment, data analysis and writing up of the first draft of the paper. Pilar del Rey: PR: Study design, patient recruitment and data collection. Ernesto Martínez: EM: Study design, patient recruitment and data collection. Acknowledgements: R.Gutiérrez, University Carlos III, Physics Department, Madrid Spain: Language help and writing assistance. M.E. López, Hospital Infantil Universitario Niño Jesús, PhD in Laboratory, Madrid Sapin. Helping with laboratory análisis. References Akgul T et al. The efficacy of cell saver method in the surgical treatment of adolescent idiopathic scoliosis. Acta Orthop Traumatol Turc. 2014; 48:303-6. Liang J et al. Does intraoperative cell salvage system effectively decrease the need for allogeneic transfusions in scoliotic patients undergoing posterior spinal fusion? A prospective randomized study. Eur Spine J. 2015;24:270-5. Muñoz Gómez, D.Ariza Villanueva, A. Romero Ruíz et al. Evaluación del sistema de autotransfusión OrthoPAT®, utilizando modelos experimentales de simulación de recuperación de sangre intra y postoperatoria. Rev.Esp. Anestesiol. Reanim. 2005; 52:321-327. National Healthcare Safety Network. Surgical Site Infection (SSI) Event. Atlanta, GA: Centers for Disease Control and Prevention; 2013. Tobias JD. Strategies for minimizing blood loss in orthopedic sugery. Semin Hematol 2004;41(Suppl 1): 145-156. Llau JV. Medicina transfusional perioperatoria. Rev Esp Anestesiol Reanim 2001;48(2):103-105. Neel Desai , Nick Schofield , Toby Richards . Perioperative Patient Blood Management to Improve Outcomes. 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Hematology Am Soc Hematol Educ Program, 2014 (1), 553-8. Alastair G.Dick , Richard J. Pinder , Shirley A. Lyle , Tom Ember , Claire Mallinson , Jonathan Lucas . Reducing Allogenic Blood Transfusion in Pediatric Scoliosis Surgery: Reporting 15 Years of a Multidisciplinary, Evidence-Based Quality Improvement Project. Global Spine J . 2019 Dec; 9(8): 843–849. doi: 1177/2192568219837488 . Fletcher ND , Marks MC , Asghar JK , Hwang SW , Sponseller PD ; Development of Consensus Based Best Practice Guidelines for Perioperative Management of Blood Loss in Patients Undergoing Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis. Spine Deform. 2018 Jul - Aug;6(4):424-429. Tables TABLE 1. Demographic variables. Average SD Median Min Max Age (Years) 14.94 2.97 15 4 20 Weight (kg) 50.58 16.2 52 17 92 Volemic status (ml) 3540.65 1134.03 3640 1190 6440 Days of stay 4.68 1.83 4 3 9 SD: standard deviation, Min: minimum value, Max: máximum value. TABLE 2. Type of scoliosis. Type of scoliosis Frequency Percentage (%) Idiopatic 21 67.74% Neuromuscular 7 22.58% Hemivertebrae 1 3.23% Secondary to syndrome 2 6.45% TOTAL 31 100% TABLE 3. Hematological characteristics of cell saver – blood. Average SD Median Min Max HTO (%) 70.38 10.03 71.90 34.20 81.80 Platelets (10 3 x µl -1 ) 50.23 59.04 38 13 295 Leukocytes(10 3 x µl -1 ) 14.36 5.47 14.48 3.17 25.89 Neutrophils (10 3 x µl -1 ) 8.93 4.26 8.13 1.25 19.20 Lymphocytes (10 3 x µl -1 ) 2.91 1.47 2.66 0.48 6.56 K + (mEq x l -1 ) 5.06 1.59 4.40 2.9 8.8 Na + (mEq x l -1 ) 141.27 4.16 144 128 144 Cl - (mEq x l -1 ) 121.03 7.07 120 102 141 SD: standard deviation, Min: minimum value, Max: máximum value, HTO: Hematocrit, K + : potasium, Na + : Sodium, Cl - : chlorine TABLE 4. Bacteria found in aerobic positive blood cultures. Frequency Percentage (%) S. epidermidis, S. capitis, S. viridans 1 8.33% S. hominis 3 25% S. saprophyticus 1 8.33% S. capitis 3 25% S. epidermidis 4 33.33% Total 12 100% S: Staphyloccocus TABLE 5. Bacteria found in anaerobic positive blood cultures. Frequency Percentage (%) Corynebacterium species 1 7.14% S. hominis 1 7.14% S. epidermidis, S. capitis, S. viridans 1 7.14% S. hominis 2 14.28% S. saprophyticus 1 7.14% S. capitis 2 14.29% S. epidermidis MR 4 28.57% Total 14 100% S: Staphyloccocus; MR: Methicillin-resistant TABLE 6. Blood tests pre and postsurgery from patients under scoliosis surgery. Preoperatative blood test Postoperative blood test P value Average SD Average SD HTO (%) 41.19 3.64 32.56 4.25 0.000 Hb (g/dl) 13.68 1.36 10.90 1.37 0.000 Platelets (10 3 x µl -1 ) 238.65 64.28 210.66 67.84 0.256 Leukocytes (10 3 x µl -1 ) 6.86 1.64 14.84 6.56 0.000 K + (mEq x l -1 ) 4.12 0.37 4.27 0.36 0.084 Na + (mEq x l -1 ) 138.93 1.96 138 3.13 0.139 Cl -1 (mEq x l -1 ) 105.14 1.96 109.59 3.68 0.000 Glu (mg/dl) 88.67 5.51 144.96 39.27 0.179 Fibrinogen 321.28 89.2 242.26 74.58 0.004 Cephaline time (seg) 26.98 3.17 25.06 4.36 0.000 Prothrombine time (seg) 94.24 12.34 70 13.46 0.000 SD: standard deviation, HTO: Hematocrit, Hb: hemoglobine, K + : potasium, Na + : Sodium, Cl - : chlorine, Glu: glucose Cite Share Download PDF Status: Published Journal Publication published 03 Jun, 2020 Read the published version in Journal of Medical Research and Health Sciences → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-22710","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":495620,"identity":"11341d13-2493-4b4d-b3dc-945522ff2c51","order_by":1,"name":"Elena García","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9UlEQVRIiWNgGAWjYDACdjApx8BwgIHxAZDFw0dQCzOYNAZpYTYAaWEjRQubBIhJUAs/M/OxBz9+GcjxHW9/Vvk1x06GjYH54aMbeLRINrOlG/b2GRhLnjmQdlt2WzLQYWzGxjl4tBgc5jGT4O35k7jhRsKx25LbmIFaeNik8WmxP8z/TfJvj0H9hvsP24olt9UT1mIANFaa54dBgsENZjbGj9sOE9YicZjNTFq2wcBw5pk0ZmnGbcd52JgJ+IW/vfmZ5Js/BvJ8x48//PhzW7U9P3vzw8f4tIABYxuEZuYBk4SUg8EfqNYfRKkeBaNgFIyCkQYAd6dFKCSp50cAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0001-5414-768X","institution":"Hospital Infantil Universitario Nino Jesus","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Elena","middleName":"","lastName":"García","suffix":""},{"id":495621,"identity":"623df1be-1a4d-4469-813c-0b438c4ca99e","order_by":2,"name":"Pilar Del Rey","email":"","orcid":"","institution":"Hospital Infantil Universitario Nino Jesus","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Pilar","middleName":"Del","lastName":"Rey","suffix":""},{"id":495622,"identity":"3168f584-9dd8-4fc4-8a17-d394f37f757b","order_by":3,"name":"Ernesto Martínez","email":"","orcid":"","institution":"Hospital Infantil Universitario Nino Jesus","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ernesto","middleName":"","lastName":"Martínez","suffix":""}],"badges":[],"createdAt":"2020-04-13 10:28:55","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-22710/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-22710/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.15520/jmrhs.v3i6.193","type":"published","date":"2020-06-03T21:22:37+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":13499076,"identity":"2b82cae5-8a8c-4a3c-859e-bbb37b3936ce","added_by":"auto","created_at":"2021-09-16 23:00:40","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":252048,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-22710/v1/125e4b48-4130-4895-994d-3825f2562a8f.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eEvaluation Of Blood Processed By Cell Saver In Pediatric Scoliosis\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eThe use of blood products transfusion has changed dramatically during the last decades. Liberal transfusion triggers have been replaced by more restrictive transfusion guidelines. This change results from an increased awareness of existing relations between allogenic transfusions and adverse reactions, and of the need to avoid overusing blood bank resources. For these reasons, new blood saving techniques have emerged in recent decades. For instance, the collection of blood from the surgical field by a device capable of processing it, such as the cell saver, so as to obtain reinfusion bags with high hematocrit percentages. Such autologous transfusion is considered to be safe as far as infection transmission and the generation of immunological problems are concerned. Futhermore, it reduces the risk of receiving allogeneic transfusions in surgeries with moderate-high bleeding, such as scoliosis surgery. Its use in pediatric surgeries is still a controversial issue, while research on its efficacy and the quality of the blood obtained in these interventions is very scarce\u003csup\u003e1,2\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eThe cell saver available for the study is the Orthopat \u0026reg;, with a pediatric hood. Two hundred mililitres of products from the surgical field are necessary to start processing blood. According to the commercial data sheet, the material available for reinfusion has around 70% hematocrit. It is expected to be free of activated coagulation factors, anticoagulant, leukocytes, platelets, cell stroma, free hemoglobin, intracellular enzymes and potassium.\u003c/p\u003e\n\u003cp\u003eHowever, the effectiveness of the red cell washing process is not yet fully clear, as other blood components could be found. The product to be reinfused might be affected by bacterial contamination at different stages of the process. The results of M. Mu\u0026ntilde;oz et al.\u003csup\u003e3\u003c/sup\u003e on experimental models with cell saver OrthoPAT\u0026reg; show that 70-95% of the content of leukocytes, platelets, cytokines and potassium is eliminated, while 80% of red blood cells is preserved.\u003c/p\u003e\n\u003cp\u003eIn this work, we study the hematological and microbiological characteristics from the autologous blood processed through the intraoperative cell saver used in our centre (Orthopat\u0026reg;) during the correction of pediatric scoliosis, which is known to be a potentially bleeding surgery. Regarding the hematological study, we test the effectiveness of the cell saver for obtaining high concentrations of functioning red blood cells, which according to the commercial data for adult patients should be 70%. Furthermore, we evaluate the hemolysis index of the blood samples as well as the possible analytical parameters derived from the red blood cell rupture, in cases where their measurement is technically possible.\u003cbr /\u003e In recent decades there have been great advances in the management of surgical bleeding, which has markedly decreased. We nonetheless compare pre- and post-operative blood tests of patients after reinfusion in order to check whether differences continue to be significant with the available blood saving methods.\u003cbr /\u003e On the other hand, we determine the microbiological characteristics of the blood obtained by the cell saver (Orthopat\u0026reg;). The appearance of fever after the reinfusion of the processed blood, as well as possible surgical site infections (SSI) during the postoperative one-month follow-up period, are monitored and their relation to positive blood cultures is studied.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis is a prospective observational study of 31 patients undergoing surgery for pediatric scoliosis. The main aim is to determine the effectiveness of the intraoperative Orthopat\u0026reg; cell saver with a pediatric hood by analyzing the hematological and microbiological characteristics of the obtained blood. The study was approved by the Ethics Committee of Ni\u0026ntilde;o Jes\u0026uacute;s Children\u0026rsquo;s University Hospital in February 2019. The data collection began immediately after the approval, and continued until November 2019.\u003c/p\u003e\n\u003cp\u003eAll patients included in the study suffered from pediatric scoliosis, and underwent posterior dorsal fusion surgery, during which the intraoperative cell saver was used. The parents/legal tutors of all participants signed a prior informed consent, as also did the patients themselves if they were over 12 years old.\u003c/p\u003e\n\u003cp\u003ePatients for which the use of the cell saver was contraindicated (oncological patients, presence of infection...) were excluded from the study. Some cases were discarded due to loss of blood samples, inability to monitor infections during follow-up and cancelled surgeries.\u003c/p\u003e\n\u003cp\u003eThe patients were anesthesized folllowing the general anesthetic method of the Anesthesiology Department of our center. Perfusion of 10 mg / kg / h of tranexamic acid with an initial bolus of 15-20 mg / kg and preoperative antibiotic prophylaxis with 30 mg / kg up to 2g of cefazolin were administered. The blood was vacuumed from the surgical field with a negative pressure of less than 150 mmHg. It was subsequently mixed with heparinized physiological serum (30U / ml) to be stored in the cell saver reservoir until the centrifuge hood was filled with 200ml. Then the blood began to be processed at a speed of 8000 rpm and was finally washed with 500 ml of physiological serum to obtain the red blood cell concentrates.\u003c/p\u003e\n\u003cp\u003eThe variables considered in the study were patient age, weight, volemia, volume of blood from the cell saver, type of scoliosis (idiopathic, neuromuscular, associated with syndromes or hemivertebrae), and hematocrit, hemoglobin, platelets, leukocytes and basic biochemistry of the patient's preoperative and postoperative blood tests. It is important to mention that the postoperative blood sample was taken upon arrival of the patient to the Postoperative Recovery Unit after the autologous blood was transfused in the operating room. From the autologous blood we analyzed: Hematocrit, hemoglobin, platelets, leukocytes and ions, as well as blood cultures and hemolysis index, which is a colorimetric test for semiquantitative determination of hemolysis in human serum and plasma in Beckman Coulter AU analyzers\u0026reg;. Patient samples are diluted in the lithium hydride reagent and the absorbency is measured in 6 wavelengths. If a sample has one or more chromogens in a potentially interfering concentration, the corresponding indicators will be generated and communicated with the results of the analyzes performed on that sample.\u003cbr /\u003e These indicators characterize the type of chromatic substance (hemoglobin) and the approximate concentration of the interference by concentration sections. The samples were taken at the time of reinfusion of the obtained blood to the patient with the greatest possible asepsis. The appearance of fever (\u0026gt; 38 \u003csup\u003eo\u003c/sup\u003eC) was monitored during the reinfusion of autologous blood. Moreover, days of hospital stay after surgery and surgical site infection (SSI) during a follow-up period of one month were recorded. For them, the most widely used definition of SSI has been provided by CDC\u003csup\u003e4\u003c/sup\u003e. According to it, SSIs are classified by depth and tissue spaces involved.\u003c/p\u003e\n\u003cp\u003eThe statistical analysis of the quantitative variables is given in terms of means, medians, standard deviations, minimum and maximum values. Qualitative variables are expressed as absolute frequencies and percentages. The mean values of pre and postoperative blood tests were compared with the Wilcoxon test. To establish the relationship between two quantitative variables, Pearson's correlation coefficient was used. All tests have been considered significant\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe demographic results and the volume obtained after blood processing are shown in Table 1. Regarding the sex of the patients 23 (74.19%) of them were girls and 8 (25.8%) boys. The type of surgery is shown in Table 2, observing a majority of scoliosis of idiopathic origin. Table 3 shows the hematological characteristics of the blood obtained from the cell saver.\u003c/p\u003e\n\u003cp\u003eThe hemolysis index is 5.48 (ds 1.73), its maximum value is 6. The average volume recovered of red blood cells is 288.06 ml (ds 154.68) with a minimum value of 50 ml and a maximum of 700 ml. The correlation between the volume processed and the hematocrit of the recovered blood: Pearson, r = 0.4426; p = 0.0126. Therefore, the greater the volume of blood recovered, the greater hematocrit is obtained in the processed red blood cell concentrate.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Regarding the possible predictors of the volume recovered, we found only a relationship in the preoperative hematocrit: Pearson 0.42, p 0.02. According to the statistical regression model, the coefficient is 7.02 (p \u0026lt;0.001, 95% CI 5.69-8.35). This indicates that an increase of 1% in preoperative hematocrit predicts 7.02 ml more in red blood cells concentrates obteined through the cell saver.\u003c/p\u003e\n\u003cp\u003eMicrobiological characteristics of recovered autologous blood:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The blood culture of the blood from the cell saver was positive in 12 cases (42.86%) of a total of 28 samples analyzed since three did not reach the microbiology laboratory. The types of bacteria found are shown in Tables 4 (aerobic germs) and 5 (anaerobic germs). All correspond with non-pathogenic bacteria from cutaneous flora. Clarify that there are species that appear in both tables since it can be an aerobic or anaerobic facultative bacteria. Any patient had fever during the infusiono f autologous blood. Four of them (12.90%) presented infectious complications in the first postoperative month. All cases were infection associated with surgical wound, just one of them required emergency surgery. Only two patients with infectious complications presented positive blood culture in the blood from cell saver. Chi-square does not show statistical significance to relate infectious complications with contamination of blood bags (p\u0026gt; 0.05).\u003c/p\u003e\n\u003cp\u003eIn the comparative study of the analytical samples of the pre-surgery and post-surgery patients, significant differences were found (p \u0026lt;0.05) in the value of: Hemoglobin, hematocrit, with both decrease in the postoperative period, prothrombin time, INR, time of cephalin, fibrinogen, with a decrease in the postoperative period and tendency to coagulopathy. All analytical parameters are shown in table 6.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur main objective has been to analyze the characteristics of the blood processed by the cell saver in pediatric scoliosis surgery. It is a blood saving technique which is increasingly used in\u0026nbsp;major orthopedic surgery to avoid risks of allogeneic transfusions, such as transmission of viral\u0026nbsp;diseases, risks associated with the storage of blood bags, blood group identification errors and\u0026nbsp;potential decrease of immunomodulation5,6. It constitutes one aspect of the multidisciplinary\u0026nbsp;approach to \"patient blood management\" 7,8, together with preoperative optimization,\u0026nbsp;administration of tranexamic acid, ensuring a careful surgical technique with hemostasis,\u0026nbsp;posterior surgical approach and lower transfusion triggers9.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOur results reveal that the percentage of hematocrit obtained, which is 70.38%, is similar to\u0026nbsp;that described by the technical data provided by OrthoPat\u0026reg; for adult patients, namely, 75%. In\u0026nbsp;agreement with previous studies 10-12, the blood from the cell saver presents much higher\u0026nbsp;levels of hematocrit than patient blood (30-45%) and also higher than that present in red\u0026nbsp;blood cell concentrates from donors (50-65%), which is quite variable. However, leukocytes\u0026nbsp;are not completely eliminated from our sample, in fact their quantity is similar to the levels\u0026nbsp;found in patient postoperative analysis. Several studies13,14 have further analyzed the presence\u0026nbsp;of different types of white cells and inflammatory molecules in the collected blood and their\u0026nbsp;relationship with postoperative infection or days of admission. Nevertheless, no relationship or\u0026nbsp;differences have been established. What seems to be clearer is the lower immunomodulatory\u0026nbsp;response of autologous blood with respect to allogeneic blood transfusion15.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eImmunomodulation seems to be especially important in cancer patients. The use of cell saver\u0026nbsp;in these cases is still controversial because of the risk of cancer cell spreading. On the other\u0026nbsp;hand, the transfusion of autologous blood would reduce the risk of immunosuppression\u0026nbsp;caused by allogeneic blood transfusion16,17.\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere is no agreement on potential effects of the presence of leukocytes in the processed\u0026nbsp;blood. Special filters for their elimination increase the cost and affect the flow conditions\u0026nbsp;during retransfusion, resulting in the activation of the complement system. In the case of\u0026nbsp;immunosuppressed or cancer patients, leucodepletion of these concentrates could be\u0026nbsp;considered for safety reasons during major orthopedic surgery18,19.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe amount of platelets in autologous blood is, despite its great variability, consistently smaller\u0026nbsp;than that found in pre and postoperative blood samples of the patient. These platelets levels\u0026nbsp;are consistent with previous studies20,21. They suggest that the processing of platelets by the\u0026nbsp; cell saver is more efficient than in the case of leukocytes. According to M. Mu\u0026ntilde;oz et al.3, the\u0026nbsp;processing of platelets in a postoperative recovery model with OrthoPAT\u0026reg; would in fact reach\u0026nbsp;88%. The importance of reinfusion of processed platelets is not clear, but it may not be\u0026nbsp;functional due to the discontinuous centrifugation of this device.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe hemolysis index is close to the maximum, which indicates that in the blood from the cell\u0026nbsp;saver there is a high level of red blood cell breakdown. In experimental models of processed\u0026nbsp;blood3 the concentration of free hemoglobin in plasma was reduced by 96% with the\u0026nbsp;OrthoPAT\u0026reg; cell saver. As for the ions, potassium deserves special attention since a rapid\u0026nbsp;reinfusion of high levels can have serious consequences. Its elimination in experimental\u0026nbsp;models is around 97%3. None of our patients showed ECG abnormalities or significantly\u0026nbsp;increased concentrations of this ion in the subsequent gasometric controls, despite the fact\u0026nbsp;that some cases presented high concentrations of around 8 mEq x l-1. Nevertheless, the total\u0026nbsp;amount of potassium in the autologous blood transfused to the patient is unlikely to be\u0026nbsp;harmful. The levels of sodium and chlorine that ensure homeostasis for cell preservation are\u0026nbsp;found to be similar to those in the patient blood.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe volume of red blood cells from the cell saver is directly related to the hematocrit thereof.\u0026nbsp;The minimum volume obtained is 50ml, which corresponds to a 17 kg patient undergoing\u0026nbsp;neuromuscular scoliosis. For this type of patients, with weights less than 25 kg, it might be\u0026nbsp;advisable to process blood with continuous processing devices, in order to obtain the largest\u0026nbsp;possible reinfusible volumes and increased hematocrit concentrations22,23.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAccording to the microbiological analysis of the samples of autologous blood, despite surgical\u0026nbsp;asepsis and antibiotic prophylaxis, it is inevitable that bacterial contamination will appear in\u0026nbsp;almost half of the cases (42.86%). These data are consistent with previous publications24-29 in\u0026nbsp;which the contamination exceeds 40%. However, the reinfusion of this contaminated blood\u0026nbsp;did not cause a higher incidence of fever or SSI, in agreement with the findings of the\u0026nbsp;previously mentioned studies. As the isolated bacteria come from skin and environmental\u0026nbsp;flora, no pathogenic germ has been found, which indicates good asepsis procedures and\u0026nbsp;correct antibiotic prophylaxis of our patients. Many factors may be responsible for\u0026nbsp;contamination of the blood processed, including a prolonged exposure of a wide surgical field,\u0026nbsp;which is characteristic of scoliosis surgery, complex and multiple instrumentation, many\u0026nbsp;professionals working in the surgical field, including the replacement of team members, as well\u0026nbsp;as multiple manipulations of vascular access and fluid administration among others.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConcerning immunocompromised patients, the use of a cell saver could contribute to the\u0026nbsp;development of infections. To prevent this risk, adding antibiotics to the samples of processed\u0026nbsp;blood in addition to applying leucodeplection should be considered as additional measures30,31. Another very different case is the immunocompetent patient, as are the majority of patients\u0026nbsp;undergoing pediatric scoliosis. With careful aseptic techniques, adequate antibiotic prophylaxis\u0026nbsp;and not exceeding the storage time of the blood concentrates (6 hours at room temperature\u0026nbsp;or refrigerated at 4 \u0026deg;C for 24 hours), it continues to be a safe technique. The ranges of SSI in\u0026nbsp;pediatric scoliosis can vary from 0.5% to more than 25% depending mainly on whether or not\u0026nbsp;of the scoliosis is of neuromuscular origin32,33. The latter consitutes a risk factor, together with\u0026nbsp;the length fo the stay, surgical instrumentation, the surgical intervention of the sacrum, the\u0026nbsp;incorrect administration of antibiotic prophylaxis or the persistence of postoperative spine\u0026nbsp;curvature34.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePediatric scoliosis surgery remains one of the surgeries with the highest bleeding rates35. In the\u0026nbsp;present study, analytical differences between the preoperative and the immediate\u0026nbsp;postoperative period have been observed. The implication is that one should continue\u0026nbsp;applying and introducing new blood-saving measures. The analysis of preoperative hemoglobin\u0026nbsp;revealed that 25% of the patients had a value of less than 13 g / dl, with a minimum of 10.4 g / According to this results, there are patients (\u0026lt;25%) with preoperative hemoglobin around\u0026nbsp;or below the limit to be considered anemic. Following the multidisciplinary approach of\u0026nbsp;\u0026ldquo;Patient Blood Management\u0026rdquo;, preoperative anemia should be optimized to reduce days of stay\u0026nbsp;and perioperative transfusions 36-38. One of the goals of our center in this regard is that no\u0026nbsp;anemic patient without prior optimization should undergo such surgery. As the associated\u0026nbsp;blood loss is considerable, and it is a programmed surgery, its date could be delayed until the\u0026nbsp;patient's condition improves. In addition, we observe how the preoperative hematocrit is\u0026nbsp;directly related to the volume of autologus blood obtained. Our results show that scoliosis\u0026nbsp;surgery continues to cause coagulopathy and a decrease in hemoglobin level (pre-surgery\u0026nbsp;13.68 g / dl, post-surgery 10.90 g / dl). To prevent such undesired effects, it is necessary to\u0026nbsp;reduce bleeding by means of pharmacological agents (tranexamic acid), maintenance of low\u0026nbsp;arterial pressure, hemodilution with fluid therapy, intraoperative techniques applied by\u0026nbsp;surgeons to improve hemostasis, the use of cell saver and restrictive transfusion triggers to\u0026nbsp;contribute to the reduction of transfusion ratios. These measures are reviewed and carried out\u0026nbsp;according to the latest guidelines on blood management in pediatric scoliosis surgery39,40.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe main limitation of our study is the small sample size. To obtain stronger results, it would\u0026nbsp;be necessary to expand it. Moreover, it is a heterogeneous group of patients in terms of\u0026nbsp;weight and origin of their scoliosis, among other factors. For instance, neuromuscular scoliosis\u0026nbsp;is associated in most cases with increased morbidity and a higher risk of bleeding. In addition,\u0026nbsp;other influential factors in bleeding such as the number of fusion levels or Cobb angle are not\u0026nbsp;considered. We should also stress that this is a prospective study conducted in a single center.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFrom our results we conclude that, in the pediatric patient, the cell saver used in this study\u0026nbsp;obtains red blood cell concentrates with a percentage of hematocrit which is in agreement\u0026nbsp;with commercial information. The reinfusion of this product seems safe from an infectious and\u0026nbsp;biochemical point of view. Its implications at the immunological level are not fully clarified\u0026nbsp;either in the previous literature or in our study. Broader studies that are specifically focused on this last aspect would be helpful in this regard.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003ePediatric spinal fusion has a specific set of risk factors for transfusion and different \nperioperative requirements. A deeper knowledge of blood management techniques is \nimproving surgical planning, as well as limiting the risks associated with transfusion, \nmaintaining hemostasis and optimizing results in these patients. This surgery still entails an \nimportant loss of blood with repercussions for the early recovery of patients. Blood saving \nmeasures taken by the surgical team are necessary. Improving outcomes, including the \nreduction of perioperative risks, depends critically on them.\n\u003c/p\u003e"},{"header":"List Of Abbreviations","content":"Sd – standard deviation\nRBC – red blood cell\nSSI – surgical site infection\nCDC – Centers for disease Control and Prevention\nINR – International Normalized Ratio\n"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe parents / guardians of the participants were asked to sign an informed consent document once they had been informed verbally and through an information sheet to parents / guardians and had been able to express and solve any doubts regarding their participation in the present study.\u003c/p\u003e\n\u003cp\u003eThis study is approved by the Ethics comitted of our Hospital: CEIm Hospital Infantil Universitario Ni\u0026ntilde;o Jes\u0026uacute;s; which is officially listed by the Ministery of our country: \u003ca href=\"https://www.aemps.gob.es/investigacionClinica/medicamentos/docs/listado-comites-investigacion-clinica.pdf\"\u003ehttps://www.aemps.gob.es/investigacionClinica/medicamentos/docs/listado-comites-investigacion-clinica.pdf\u003c/a\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot aplicable, there is not individual data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo sources of financial assistance or potential conflicts of interest.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDetails of authors' contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eElena Garc\u0026iacute;a, EG: Study design, patient recruitment, data analysis and writing up of the first draft of the paper.\u003c/p\u003e\n\u003cp\u003ePilar del Rey: PR: Study design, patient recruitment and data collection.\u003c/p\u003e\n\u003cp\u003eErnesto Mart\u0026iacute;nez: EM: Study design, patient recruitment and data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eR.Guti\u0026eacute;rrez, University Carlos III, Physics Department, Madrid Spain: Language help and writing assistance.\u003c/p\u003e\n\u003cp\u003eM.E. L\u0026oacute;pez, Hospital Infantil Universitario Ni\u0026ntilde;o Jes\u0026uacute;s, PhD in Laboratory, Madrid Sapin. Helping with laboratory an\u0026aacute;lisis.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003e\u0026nbsp;Akgul T et al. The efficacy of cell saver method in the surgical treatment of adolescent idiopathic scoliosis. Acta Orthop Traumatol Turc. 2014; 48:303-6.\u003c/li\u003e\n\u003cli\u003eLiang J et al. Does intraoperative cell salvage system effectively decrease the need for allogeneic transfusions in scoliotic patients undergoing posterior spinal fusion? A prospective randomized study. Eur Spine J. 2015;24:270-5.\u003c/li\u003e\n\u003cli\u003eMu\u0026ntilde;oz G\u0026oacute;mez, D.Ariza Villanueva, A. Romero Ru\u0026iacute;z et al. 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Perioperative Blood Management in Pediatric Spine Surgery. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28644187\"\u003eJ Am Acad Orthop Surg.\u003c/a\u003e 2017 Jul;25(7):480-488.\u003c/li\u003e\n\u003cli\u003e\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/?term=Fontanals+M\u0026amp;cauthor_id=30499592\"\u003eMontserrat Fontanals\u003c/a\u003e ,\u0026nbsp;\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/?term=O%27Leary+JD\u0026amp;cauthor_id=30499592\"\u003eJames D O'Leary\u003c/a\u003e\u003csup\u003e\u0026nbsp;\u003c/sup\u003e ,\u0026nbsp;\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/?term=Zaarour+C\u0026amp;cauthor_id=30499592\"\u003eChristian Zaarour\u003c/a\u003e et al. Preoperative Anemia Increases the Risk of Red Blood Cell Transfusion and Prolonged Hospital Length of Stay in Children Undergoing Spine Arthrodesis Surgery. Transfusion, 59 (2), 492-499, Feb 2019,\u003c/li\u003e\n\u003cli\u003e\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/?term=Resar+LM\u0026amp;cauthor_id=25696910\"\u003eLinda M S Resar\u003c/a\u003e,\u0026nbsp;\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/?term=Frank+SM\u0026amp;cauthor_id=25696910\"\u003eSteven M Frank\u003c/a\u003e. Bloodless Medicine: What to Do When You Can't Transfuse. Hematology Am Soc Hematol Educ Program, 2014 (1), 553-8.\u003c/li\u003e\n\u003cli\u003e\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Dick%20AG%5BAuthor%5D\u0026amp;cauthor=true\u0026amp;cauthor_uid=31819850\"\u003eAlastair G.Dick\u003c/a\u003e, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Pinder%20RJ%5BAuthor%5D\u0026amp;cauthor=true\u0026amp;cauthor_uid=31819850\"\u003eRichard J. Pinder\u003c/a\u003e, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Lyle%20SA%5BAuthor%5D\u0026amp;cauthor=true\u0026amp;cauthor_uid=31819850\"\u003eShirley A. Lyle\u003c/a\u003e, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Ember%20T%5BAuthor%5D\u0026amp;cauthor=true\u0026amp;cauthor_uid=31819850\"\u003eTom Ember\u003c/a\u003e, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Mallinson%20C%5BAuthor%5D\u0026amp;cauthor=true\u0026amp;cauthor_uid=31819850\"\u003eClaire Mallinson\u003c/a\u003e, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Lucas%20J%5BAuthor%5D\u0026amp;cauthor=true\u0026amp;cauthor_uid=31819850\"\u003eJonathan Lucas\u003c/a\u003e. Reducing Allogenic Blood Transfusion in Pediatric Scoliosis Surgery: Reporting 15 Years of a Multidisciplinary, Evidence-Based Quality Improvement Project. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882095/\"\u003eGlobal Spine J\u003c/a\u003e. 2019 Dec; 9(8): 843\u0026ndash;849. doi:\u0026nbsp;\u003ca href=\"https://dx.doi.org/10.1177%2F2192568219837488\"\u003e1177/2192568219837488\u003c/a\u003e.\u003c/li\u003e\n\u003cli\u003e\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Fletcher%20ND%5BAuthor%5D\u0026amp;cauthor=true\u0026amp;cauthor_uid=29886914\"\u003eFletcher ND\u003c/a\u003e, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Marks%20MC%5BAuthor%5D\u0026amp;cauthor=true\u0026amp;cauthor_uid=29886914\"\u003eMarks MC\u003c/a\u003e, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Asghar%20JK%5BAuthor%5D\u0026amp;cauthor=true\u0026amp;cauthor_uid=29886914\"\u003eAsghar JK\u003c/a\u003e, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Hwang%20SW%5BAuthor%5D\u0026amp;cauthor=true\u0026amp;cauthor_uid=29886914\"\u003eHwang SW\u003c/a\u003e, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Sponseller%20PD%5BAuthor%5D\u0026amp;cauthor=true\u0026amp;cauthor_uid=29886914\"\u003eSponseller PD\u003c/a\u003e; Development of Consensus Based Best Practice Guidelines for Perioperative Management of Blood Loss in Patients Undergoing Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29886914\"\u003eSpine Deform.\u003c/a\u003e 2018 Jul - Aug;6(4):424-429.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: Helvetica; font-size: 12px;\"\u003eTABLE 1. Demographic variables.\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.75pt;border: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.75pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eAverage\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eSD\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eMedian\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eMin\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eMax\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.75pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eAge (Years)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.75pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e14.94\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.97\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e15\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e20\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.75pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eWeight (kg)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.75pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e50.58\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e16.2\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e52\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e17\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e92\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.75pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eVolemic status (ml)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.75pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3540.65\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1134.03\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3640\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1190\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e6440\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.75pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eDays of stay\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.75pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4.68\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.83\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e9\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cem\u003eSD: standard deviation, Min: minimum\u0026nbsp;\u003c/em\u003e\u003cem\u003evalue, Max: m\u0026aacute;ximum value.\u003c/em\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTABLE 2. Type of scoliosis.\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eType of scoliosis\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eFrequency\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePercentage (%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eIdiopatic\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e21\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e67.74%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eNeuromuscular\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e7\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e22.58%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eHemivertebrae\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3.23%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eSecondary to syndrome\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e6.45%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTOTAL\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e31\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e100%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTABLE 3. Hematological characteristics of cell saver \u0026ndash; blood.\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width:424.75pt;border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.65pt;border: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.65pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eAverage\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eSD\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.6pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eMedian\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eMin\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eMax\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.65pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eHTO (%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.65pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e70.38\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e10.03\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e71.90\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e34.20\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e81.80\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.65pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePlatelets (10\u003csup\u003e3\u0026nbsp;\u003c/sup\u003ex \u0026micro;l\u003csup\u003e-1\u003c/sup\u003e)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.65pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e50.23\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e59.04\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e38\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e13\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e295\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.65pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eLeukocytes(10\u003csup\u003e3\u0026nbsp;\u003c/sup\u003ex \u0026micro;l\u003csup\u003e-1\u003c/sup\u003e)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.65pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e14.36\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e5.47\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e14.48\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3.17\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e25.89\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.65pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eNeutrophils (10\u003csup\u003e3\u0026nbsp;\u003c/sup\u003ex \u0026micro;l\u003csup\u003e-1\u003c/sup\u003e)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.65pt;border-top: 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none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e121.03\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e7.07\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e120\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e102\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68.95pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e141\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cem\u003eSD: standard deviation, Min: minimum value, Max:\u0026nbsp;\u003c/em\u003e\u003cem\u003em\u0026aacute;ximum value, HTO: Hematocrit, K\u003csup\u003e+\u003c/sup\u003e: potasium, Na\u003csup\u003e+\u003c/sup\u003e: Sodium, Cl\u003csup\u003e-\u003c/sup\u003e: chlorine\u003c/em\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTABLE 4. Bacteria found in aerobic positive blood cultures.\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 169.85pt;border: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113.25pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eFrequency\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePercentage (%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 169.85pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eS. epidermidis, S. capitis, S. viridans\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113.25pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e8.33%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 169.85pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eS. hominis\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113.25pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e25%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 169.85pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eS. saprophyticus\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113.25pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e8.33%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 169.85pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eS. capitis\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113.25pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e25%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 169.85pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eS. epidermidis\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113.25pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e33.33%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 169.85pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTotal\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113.25pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e12\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e100%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cem\u003eS: Staphyloccocus\u003c/em\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTABLE 5. Bacteria found in anaerobic positive blood cultures.\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eFrequency\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePercentage (%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eCorynebacterium species\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e7.14%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eS. hominis\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e7.14%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eS. epidermidis, S. capitis, S. viridans\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e7.14%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eS. hominis\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e14.28%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eS. saprophyticus\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e7.14%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eS. capitis\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e14.29%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eS. epidermidis MR\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e28.57%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTotal\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e14\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 141.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e100%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cem\u003eS: Staphyloccocus; MR: Methicillin-resistant\u003c/em\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTABLE 6. Blood tests pre and postsurgery from patients under scoliosis surgery.\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 113.15pt;border: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 127.6pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePreoperatative blood test\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 127.55pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePostoperative blood test\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 56.4pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eP value\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 56.7pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eAverage\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;SD\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eAverage\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.75pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eSD\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113.15pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eHTO (%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.7pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e41.19\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3.64\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e32.56\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.75pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4.25\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.000\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113.15pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eHb (g/dl)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.7pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e13.68\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.36\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e10.90\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.75pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.37\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.000\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113.15pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePlatelets (10\u003csup\u003e3\u0026nbsp;\u003c/sup\u003ex \u0026micro;l\u003csup\u003e-1\u003c/sup\u003e)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.7pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e238.65\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e64.28\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.8pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e210.66\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.75pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e67.84\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: 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63.75pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e6.56\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n 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windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eNa\u003csup\u003e+\u0026nbsp;\u003c/sup\u003e(mEq x l\u003csup\u003e-1\u003c/sup\u003e)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.7pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: 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windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e138\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.75pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 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style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eCl\u003csup\u003e-1\u0026nbsp;\u003c/sup\u003e(mEq x l\u003csup\u003e-1\u003c/sup\u003e)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.7pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 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Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.000\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cem\u003eSD: standard deviation, HTO: Hematocrit, Hb: hemoglobine, K\u003c/em\u003e\u003cem\u003e\u003csup\u003e+\u003c/sup\u003e\u003c/em\u003e\u003cem\u003e: potasium, Na\u003csup\u003e+\u003c/sup\u003e: Sodium, Cl\u003csup\u003e-\u003c/sup\u003e: chlorine, Glu: glucose\u003c/em\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: Helvetica; font-size: 12px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"autologous-transfusion, bloodless medicine, cell-saver, inmunomodulation, pediatric-scoliosis, blood test.","lastPublishedDoi":"10.21203/rs.3.rs-22710/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-22710/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eIntroduction We study the hematological and microbiological characteristics from the autologous blood processed through the intraoperative cell saver used in our centre (Orthopat®) during the correction of pediatric scoliosis, which is known to be a potentially bleeding surgery. \u003c/p\u003e\u003cp\u003eMaterial and methods Descriptive analysis of 31 patients undergoing pediatric scoliosis surgery. All of them received blood processed by cell saver intraoperatively. The variables collected were: demographic data, volume of the autogenous red blood cell (RBC) concentrate, blood count, biochemistry, blood culture, preoperative and postoperative blood tests of the patients, incidence of fever during reinfusion of RBC concentrate, postoperative surgical site infections and length of hospital stay. \u003c/p\u003e\u003cp\u003eResults Average volume obtained 288.06ml (sd 154.68). Hematocrit 70.38% (ds 10.03) in accordance with cell-saver commercial data (75%). Of the blood samples obtained, 42.86% had blood cultures that were positive for aerobes and 48.28% for anaerobes. The relation between postoperative infections and contamination of blood concentrates was not statistically significant. When comparing the pre-surgery and post-surgery analytical samples, statistically significant differences (p \u0026lt;0.05) were found in the following: hemoglobin and hematocrit decreased in the postoperative period, while coagulation parameters show a tendency to coagulopathy.\u003c/p\u003e\u003cp\u003eConclusion Our cell saver obtains RBC concentrates with a percentage of hematocrit in agreement with available information. The reinfusion of them is safe from an infectious and biochemical point of view, but its immunological implications are not clear. This surgery continues to result in a significant loss of blood. Measures taken to avoid allogenic transfusions remain necessary and should be enhanced.\u003c/p\u003e","manuscriptTitle":"Evaluation Of Blood Processed By Cell Saver In Pediatric Scoliosis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-04-20 17:09:13","doi":"10.21203/rs.3.rs-22710/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"73b15faf-5b0a-4b57-9c6a-dbf64adc3650","owner":[],"postedDate":"April 20th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":85726,"name":"Pediatrics"}],"tags":[],"updatedAt":"2021-07-22T21:22:37+00:00","versionOfRecord":{"articleIdentity":"rs-22710","link":"https://doi.org/10.15520/jmrhs.v3i6.193","journal":{"identity":"journal-of-medical-research-and-health-sciences","isVorOnly":true,"title":"Journal of Medical Research and Health Sciences"},"publishedOn":"2020-06-03 21:22:37","publishedOnDateReadable":"June 3rd, 2020"},"versionCreatedAt":"2020-04-20 17:09:13","video":"","vorDoi":"10.15520/jmrhs.v3i6.193","vorDoiUrl":"https://doi.org/10.15520/jmrhs.v3i6.193","workflowStages":[]},"version":"v1","identity":"rs-22710","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-22710","identity":"rs-22710","version":["v1"]},"buildId":"-HB7Z8yhvgn0wM9Nzuekk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}