title: Haemoconcentration of residual cardiopulmonary bypass blood using Hemosep ®: a randomised controlled trial.
abstract: Cardiac surgery and cardiopulmonary bypass are associated with haemodilution, activation of haemostasis and blood transfusion. We undertook a randomised controlled trial that included 53 patients in order to compare autotransfusion of residual cardiopulmonary bypass blood with residual blood concentrated using the novel Hemosep(®) device. There was no difference in patients' mean (SD) haemoglobin concentration after autotransfusion of unprocessed blood compared with Hemosep; 103.5 (10.2) g.l(-1) vs 106.2 (12.4) g.l(-1), respectively, p = 0.40. The mean (SD) change in haemoglobin concentration after autotransfusion was 5.9 (5.3) g.l(-1) in the control group compared with 4.9 (6.3) g.l(-1) in the Hemosep group, p = 0.545. Adjusted for baseline haemoglobin concentrations, the estimated mean (95% CI) difference in change in haemoglobin concentration (control vs Hemosep) was 0.57 (-2.65 to 3.79) g.l(-1), p = 0.72. This was despite Hemosep's reducing the weight of the blood from a mean (SD) of 778.7 (243.0) g to 607.3 (248.2) g, p < 0.001. The haemoglobin concentration in the processed blood increased from a mean (SD) of 87.0 (15.1) g.l(-1) to 103.7 (17.4) g.l(-1), p < 0.001. We conclude that Hemosep is capable of haemoconcentration when employed to process residual cardiopulmonary bypass blood, but that this is insufficient to increase patient haemoglobin.
authors.affiliation: Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, UK.
authors.forename: M
authors.initials: M
authors.lastname: Hogan
authors.forename: A
authors.initials: A
authors.lastname: Needham
authors.forename: E
authors.initials: E
authors.lastname: Ortmann
authors.forename: F
authors.initials: F
authors.lastname: Bottrill
authors.forename: T J
authors.initials: TJ
authors.lastname: Collier
authors.forename: M W
authors.initials: MW
authors.lastname: Besser
authors.forename: A A
authors.initials: AA
authors.lastname: Klein
mesh_terms: D000368:Aged; D001772:Blood Cell Count; D001780:Blood Coagulation Tests; D001804:Blood Transfusion, Autologous / Q000295:instrumentation* / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000295:instrumentation / Q000379:methods; D002315:Cardiopulmonary Bypass / Q000379:methods*; D005260:Female; D006438:Hemodilution; D006454:Hemoglobins / Q000032:analysis / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D057725:Operative Blood Salvage / Q000295:instrumentation* / Q000379:methods; D010976:Platelet Count; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins