Comparative analysis of recovery of cardiopulmonary bypass residual blood: cell saver vs. hemoconcentrator.
For surgical bleeding problems, the cell saver has been used to return shed blood; however, overuse can lead to a deficit in coagulation factors. Its usefulness has gained widespread use in many surgical settings. The hemoconcentrator can aid in raising the hematocrit level while reducing blood utilization where large blood volume and/or large amounts of irrigation are returned to the perfusion circuit. The hemoconcentrator returns red blood cells without removing coagulation factors, unlike the cell saver. In order to determine which method of returning residual blood from the cardiopulmonary bypass circuit is more desirable, blood samples were drawn both pre and post transfusion from 15 cell saver patients, and 14 hemoconcentrator patients. Twelve hour blood loss was recorded in 40 patients within each group. The fibrinogen, platelet count, total protein, albumin and white blood cell count were similar between the two groups, as was the blood loss. The only significant differences found were the post red blood cell count, post hemoglobin, and the delta hematocrit, all being higher in autotransfusion group. In conclusion, returning blood through the hemoconcentrator in the average adult perfusion circuit was not able to significantly raise certain coagulation parameters, nor reduce postoperative bleeding.
Johnson
H D
HD
Spartanburg Regional Medical Center, South Carolina, USA.
Morgan
M S
MS
Utley
J R
JR
Leyand
S A
SA
Nguyen-Duy
T
T
Crawley
D M
DM
D001777:Blood Coagulation; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001800:Blood Specimen Collection / Q000009:adverse effects / Q000295:instrumentation*; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000295:instrumentation*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000295:instrumentation*; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged