Background: The quality of shed blood processed by autotransfusion systems is governed by multiple factors which can be influenced by the operator of the system. Little is known about the specific parameters and about the underlying physical principles affecting the product quality. Material and Methods: In case of discontinuous autotransfusion systems, the processing can be subdivided into the separation phase occurring during the filling of the bowl, and the washing phase. For both phases, a simple mathematical model was derived, allowing to calculate the elimination of solutes depending on the hematocrit values prior to and after processing and on the volume of washing solution. The results obtained by the model were compared to published data. A modification of the model allows the description of multiple bowl processing. Results: Lowering the hematocrit prior to processing, increasing the hematocrit after processing, and increasing the volume of washing solution each result in improved elimination of solutes. Compared to published data, the results show good consistency for the separation phase, whereas for the washing phase, the calculated results are unrealistically high. Regarding multiple bowl processing, a partially filled last bowl can have a negative impact on the final product quality. Conclusions: The aforementioned parameters can be used to optimize the processing of shed blood by autotransfusion. A hypothetical explanation for the discrepancy found for the washing phase might be poor flushing of the sedimented erythrocytes by washing solution. Regarding the low efficiency of the washing phase, a modification of the process by completely excluding the washing phase and retaining a pure separation step should be considered.

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