[Effectiveness of the Cell Saver and salvage from ultrafiltered extracorporeal circulation in heart surgery].
The efficiency of two intraoperative techniques of blood saving were compared prospectively. During a period of eight months, in 120 adults patients undergoing heart surgery with a cardiopulmonary bypass (CPB). They all had blood removed before the start of CPB for isovolaemic haemodilution. They were randomly assigned to two groups (n = 60 for each): for group A patients, blood was salvaged during surgery before the start of the CPB, during cardioplegia, and from the CPB circuit at the end of surgery, using a Cell Saver 1V (Haemonetics), and returned to the patient in theatre or in intensive care; in group B patients, blood in the CPB circuit at the end of surgery was ultrafiltered and returned to the patient at the same time as 0.8 mg.kg-1 protamine sulfate. The same anaesthetic protocol was used in all the patients (flunitrazepam, phenoperidine and pancuronium bromide). There was no significant difference between the two groups in the volume of blood removed at the start of surgery (9.12 +/- 2.01 ml.kg-1 (A) vs. 8.85.2.22 ml.kg-1 (B)), in the amounts of replacement fluid (Haemaccel, 4% albumin) given to maintain volaemia, and in postoperative blood loss Red cell count, haemoglobin level and haematocrit were higher in the Cell Saver group at the third postoperative hour and on the first postoperative day, whereas fibrinogen levels and platelet count were higher in the ultrafiltration group at the same times. A mean of 1.02 +/- 1.71 homologous blood units were given to group A and 1.45 +/- 1.71 in group B (not significant).(ABSTRACT TRUNCATED AT 250 WORDS)
Merville
C
C
Département d'Anesthesie-Réanimation Chirurgicale, CHU Côte-de-Nacre, Caen.
Charlet
P
P
Zerr
C
C
Bricard
H
H
D000368:Aged; D001804:Blood Transfusion, Autologous / Q000295:instrumentation* / Q000379:methods; D006348:Cardiac Surgical Procedures; D004906:Erythrocyte Count; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006400:Hematocrit; D006438:Hemodilution; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011184:Postoperative Period; D011446:Prospective Studies; D014462:Ultrafiltration
D006454:Hemoglobins; D005340:Fibrinogen
Efficacité respective du Cell Saver et de la récupération du circuit de CEC ultrafiltré en chirurgie cardiaque.