Shimizu T, Kudo T, Yamaguchi H, Ishimaru S, Furukawa K
Department of Surgery, Tokyo Medical College.
Kyobu Geka. 1991 Mar;44(3):206-10.
Ultrafiltration is well known as a useful method of hemoconcentration of the blood after cardiopulmonary bypass, but free hemoglobin increase is a problem in autotransfusion. The purpose of this study was to investigate the effect of haptoglobin administration for hemolysis with autotransfused blood ultrafiltered after cardiopulmonary bypass. By means of haptoglobin administration, autotransfusion of blood ultrafiltered with Hemocon (CD Medical Inc.) composed cellulose acetate membrane was performed in patients over a long period (max 313 min) of cardiopulmonary bypass, and with high serum free hemoglobin levels (max 128 mg/dl) at the end of the cardiopulmonary bypass. Comparing the prophylactic administration with the therapeutic administration of haptoglobin, both methods effectively prevented the increment of serum free hemoglobin level, but prophylactic administration (priming administration) was safer and more useful considering free hemoglobin level in ultrafiltered blood and changes of serum free haptoglobin, free hemoglobin and creatinine clearance during and after the operation.
超滤作为体外循环后血液浓缩的一种有用方法广为人知，但自体输血时游离血红蛋白增加是一个问题。本研究的目的是探讨给予结合珠蛋白对体外循环后超滤自体输血所致溶血的影响。通过给予结合珠蛋白，在体外循环时间较长（最长313分钟）且体外循环结束时血清游离血红蛋白水平较高（最高128mg/dl）的患者中，对使用醋酸纤维素膜制成的Hemocon（CD Medical Inc.）进行超滤的血液进行自体输血。比较结合珠蛋白的预防性给药和治疗性给药，两种方法均有效防止了血清游离血红蛋白水平的升高，但考虑到超滤血液中的游离血红蛋白水平以及手术期间和术后血清游离结合珠蛋白、游离血红蛋白和肌酐清除率的变化，预防性给药（预充给药）更安全、更有效。
