Colli Andrea, Balduzzi Sara, Ruyra Xavier
Department of Cardiac Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
J Cardiothorac Surg. 2012 Jun 14;7:55. doi: 10.1186/1749-8090-7-55.
The return of extracorporeal circuit blood at the termination of cardiopulmonary bypass (CPB) is an important feature of blood conservation during cardiac surgery procedures globally. We report our initial clinical evaluation of the Hemobag system a blood-salvaging device designed for whole blood recovery of residual post-CPB volume.
Residual whole blood is hemoconcetrated through the multipass "recovery loop" circuit separate from the CPB and collected in the Hemobag System. This allows the surgeons to continue with surgery, decannulate, and administer protamine simultaneously while the Hemobag is in use and the CPB circuit remains safely primed. We have compared 25 patients receiving the Hemobag to a control group of 25 patients treated with the cell washer that represented our previous standard of care method of circuit blood-salvaging technique.
The Hemobag system provided significantly higher hemoglobin, hematocrit, fibrinogen, albumin, and total protein levels in the final product reducing the amount of wasted autologous blood cells. There were no device-related complications. There were no significant differences in terms of blood utilization, chest tube drainage and clinical outcomes over the entire postoperative period among groups.
These results suggest that the Hemobag system is a safe and efficient method to multipass hemoconcentrate the residual diluted blood of the CPB circuit. The Hemobag has demonstrated its ability to maximize the composition of the residual CPB volume to achieve the best possible post-CPB hemoglobin, plasma protein and coagulation factors profile for the patient respect to CW.
在全球心脏手术过程中,体外循环(CPB)结束时体外循环回路血液的回输是血液保护的一个重要特征。我们报告了对Hemobag系统的初步临床评估,该系统是一种用于回收CPB后残余血量全血的血液回收装置。
残余全血通过与CPB分离的多程“回收回路”进行血液浓缩,并收集在Hemobag系统中。这使得外科医生在使用Hemobag且CPB回路保持安全预充的同时能够继续进行手术、拔除插管并同时给予鱼精蛋白。我们将25例接受Hemobag治疗的患者与25例接受细胞洗涤器治疗的对照组患者进行了比较,细胞洗涤器代表了我们之前的回路血液回收技术标准护理方法。
Hemobag系统在最终产物中提供了显著更高的血红蛋白、血细胞比容、纤维蛋白原、白蛋白和总蛋白水平,减少了自体血细胞的浪费量。没有与设备相关的并发症。在整个术后期间,各组之间在血液利用、胸管引流和临床结果方面没有显著差异。
这些结果表明,Hemobag系统是一种安全有效的方法,可对CPB回路中残余的稀释血液进行多程血液浓缩。相对于细胞洗涤器,Hemobag已证明其能够最大限度地提高残余CPB血量的成分,为患者实现CPB后最佳的血红蛋白、血浆蛋白和凝血因子水平。