title: Comparative study of cell saver and ultrafiltration nontransfusion in cardiac surgery.
abstract: Hemoconcentration for the establishment of no-donor blood transfusion in open heart surgery was assessed in regard to both the saving of protein and platelets and the exclusion of free hemoglobin. Two different types of hemoconcentrator were compared: the ultrafilter (group I, 6 patients) and the Cell Saver (group II, 6 patients). The total serum protein level, expressed as the percent recovery of the preoperative value, after hemoconcentration was significantly higher in group I (group I versus group II: total serum protein, 118% versus 87% [p less than 0.05]; fibrinogen, 77% versus 50% [p less than 0.01]; immunoglobulin, 83% versus 60% [p less than 0.01]). The platelets also seemed to be well preserved after hemoconcentration in group I. Although the exclusion of free hemoglobin from plasma was inferior in group I compared with group II, the postoperative plasma free hemoglobin level did not increase in group I. We conclude that use of the Cell Saver in nontransfusion cardiopulmonary bypass might cause a severe depletion of various proteins and that the ultrafilter is both safer and more useful if employed routinely.
authors.affiliation: Division of Cardiovascular Surgery, Kyushu University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.forename: M
authors.initials: M
authors.lastname: Masuda
authors.forename: Y
authors.initials: Y
authors.lastname: Toshima
authors.forename: T
authors.initials: T
authors.lastname: Asou
authors.forename: M
authors.initials: M
authors.lastname: Oe
authors.forename: K
authors.initials: K
authors.lastname: Kinoshita
authors.forename: Y
authors.initials: Y
authors.lastname: Kawachi
authors.forename: J
authors.initials: J
authors.lastname: Tanaka
authors.forename: K
authors.initials: K
authors.lastname: Tokunaga
mesh_terms: D000328:Adult; D001798:Blood Proteins / Q000032:analysis; D001804:Blood Transfusion, Autologous / Q000295:instrumentation / Q000379:methods*; D006348:Cardiac Surgical Procedures; D002314:Cardioplegic Solutions / Q000008:administration & dosage; D002315:Cardiopulmonary Bypass / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D006400:Hematocrit; D006440:Hemofiltration / Q000295:instrumentation / Q000379:methods*; D006454:Hemoglobins / Q000032:analysis; D006470:Hemorrhage; D006801:Humans; D007668:Kidney / Q000502:physiology; D010976:Platelet Count; D014462:Ultrafiltration / Q000295:instrumentation / Q000379:methods*; D014692:Ventilation-Perfusion Ratio
chemical_list: D001798:Blood Proteins; D002314:Cardioplegic Solutions; D006454:Hemoglobins