Department of Perfusion Services, Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Perfusion. 2021 Jan;36(1):57-62. doi: 10.1177/0267659120921090. Epub 2020 May 30.
A device that may help attenuate the amount of homologous blood product given to pediatric cardiac surgical patients is the autotransfusion device. Three separate autotransfusion devices were selected for evaluation. The Sorin Xtra, Fresenius Continuous Autotransfusion System Plus (CATS), and the Fresenius Continuous Autotransfusion System Smart (CATSmart) were evaluated based on the mechanical processes of each device, hematocrit value of the salvaged packed red cell product, time of processing, and the advantageous accessories with each device.
Each of the autotransfusion devices were used to collect salvageable blood from the surgical field as well as to process residual blood from the cardiopulmonary bypass circuit after decannulation. The cell salvage process was performed in accordance with the manufacturer's instructions for use and the recommended settings for processing and washing. The Sorin Xtra device had the 55 mL bowl set up for all cases, while the Fresenius continuous autotransfusion systems utilized the standard disposable for each device.
Each cell salvage device was employed during 30 pediatric cardiac surgery procedures, and data for each device, was broken down into four groups based on patient weight (0-10, 10-20, 20-40, and >40 kg). For all patient sizes, the Sorin Xtra tended to produce the greatest volume of cell saver product (55-825 mL) as compared to the CATS and CATSmart devices (7-550 mL and 0-860 mL, respectively). The Continuous Autotransfusion System Smart tended to produce the highest hematocrit product, ranging from 44 to 81%.
Through this evaluation, it was determined the continuous autotransfusion systems provided the highest hematocrit with the lowest recovered packed red cell volume, while the Sorin Xtra packed red cell product showed to have a lower hematocrit with a larger packed red cell volume. Each device proved effective within our pediatric population.
一种可能有助于减少儿科心脏外科患者给予同源血液制品量的设备是自体输血装置。选择了三种独立的自体输血设备进行评估。根据每个设备的机械过程、回收的浓缩红细胞产品的血细胞比容值、处理时间以及每个设备的附加优势附件，对 Sorin Xtra、费森尤斯连续自动输血系统加（CATS）和费森尤斯连续自动输血系统智能（CATSmart）进行了评估。
每个自体输血设备都用于从手术部位收集可回收的血液，并处理体外循环脱管后的剩余血液。细胞回收过程按照制造商的使用说明和处理及清洗的推荐设置进行。Sorin Xtra 设备使用所有情况下的 55ml 碗，而费森尤斯连续自动输血系统则为每个设备使用标准一次性用品。
每个细胞回收设备都在 30 例儿科心脏手术中使用，每个设备的数据按患者体重（0-10、10-20、20-40 和>40kg）分为四组。对于所有患者体型，Sorin Xtra 设备产生的细胞保存产品量最大（55-825ml），而 CATS 和 CATSmart 设备的产品量分别为 7-550ml 和 0-860ml。连续自动输血系统 Smart 产生的血细胞比容产品最高，范围从 44%到 81%。
通过这项评估，确定连续自动输血系统提供了最高的血细胞比容，同时回收的浓缩红细胞量最低，而 Sorin Xtra 浓缩红细胞产品的血细胞比容较低，但浓缩红细胞量较大。每个设备在我们的儿科人群中都被证明是有效的。
