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一种新型心脏手术止血器（HEMOBLAST）的应用技术

Application techniques of a novel hemostat in cardiac operations: HEMOBLAST.

作者信息

Bruckner Brian A, Ngo Uy, Ramchandani Mahesh, Suarez Erik, Awad Samir, Reardon Michael

机构信息

Houston Methodist Hospital, Methodist DeBakey Heart & Vascular Center, Houston, Texas.

Department of Surgery, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.

出版信息

J Card Surg. 2019 Sep;34(9):849-853. doi: 10.1111/jocs.14171. Epub 2019 Jul 26.

DOI:10.1111/jocs.14171
PMID:31348840
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6773212/
Abstract

BACKGROUND

Postoperative bleeding complications are associated with less favorable outcomes in cardiac surgery and contribute to excessive overall healthcare costs. HEMOBLAST (Biom'up, Lyon, France) (HB) is a novel ready-to-use hemostatic powder that consists of porcine collagen, bovine chondroitin sulfate, and human pooled plasma thrombin that may help reduce surgical bleeding.

AIMS

The aim of this study was to describe the techniques of application for this new combination powder-based hemostat, HB, and demonstrate its use employing photographs of application methods during cardiac procedures.

MATERIALS AND METHODS

The initial 24 procedures in which HB was used at our institution included: left ventricular assist device (LVAD) insertions, lung transplants, heart transplants, aortic valve replacements, coronary artery bypass grafting, and mitral valve repair.

RESULTS

Hemostasis was achieved in all cases and there were no instances of mediastinitis, sternal infections, allergic reactions, or 30-day mortality.

DISCUSSION

This report describes the best methods of application of HB including use for treatment of mediastinal bleeding in a re-operative procedure in a patient on antiplatelet agents and sternal bleeding during an LVAD insertion. Proper application can facilitate excellent hemostasis using this powder.

CONCLUSION

HB is a novel powder-based multiple component hemostatic agent that promotes focal or large area hemostasis. We have presented the techniques of use that are important to the successful application of HB to facilitate hemostasis.

摘要

背景

术后出血并发症与心脏手术中较差的预后相关，并导致总体医疗费用过高。HEMOBLAST（法国里昂Biom'up公司）（HB）是一种新型即用型止血粉，由猪胶原蛋白、硫酸软骨素和人混合血浆凝血酶组成，可能有助于减少手术出血。

目的

本研究的目的是描述这种新型基于粉末的复合止血剂HB的应用技术，并通过心脏手术中应用方法的照片展示其使用情况。

材料与方法

在我们机构使用HB的最初24例手术包括：左心室辅助装置（LVAD）植入、肺移植、心脏移植、主动脉瓣置换、冠状动脉搭桥术和二尖瓣修复。

结果

所有病例均实现止血，未发生纵隔炎、胸骨感染、过敏反应或30天死亡率。

讨论

本报告描述了HB的最佳应用方法，包括在接受抗血小板药物治疗的患者再次手术中用于治疗纵隔出血，以及在LVAD植入过程中用于治疗胸骨出血。正确应用可使用这种粉末促进出色的止血效果。

结论

HB是一种新型的基于粉末的多成分止血剂，可促进局部或大面积止血。我们介绍了对成功应用HB以促进止血很重要的使用技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a6c/6773212/8909f9e2e6c8/JOCS-34-849-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a6c/6773212/453127a1e02a/JOCS-34-849-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a6c/6773212/a06dd10f21ff/JOCS-34-849-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a6c/6773212/8909f9e2e6c8/JOCS-34-849-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a6c/6773212/453127a1e02a/JOCS-34-849-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a6c/6773212/a06dd10f21ff/JOCS-34-849-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a6c/6773212/8909f9e2e6c8/JOCS-34-849-g003.jpg

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本文引用的文献

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