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体外循环期间SafeCEC单向阀溶血情况的临床评估:初步研究

Clinical evaluation of SafeCEC one-way valve in hemolysis during CPB: Pilot study.

作者信息

Coutinho Henrique Madureira da Rocha, Coutinho Joaquim Henrique de Souza Aguiar, Torres José Hamilton, Casanova Rafaela Mourão, Kikuta Gustavo, Reis Edison Emídio

机构信息

Division of Cardiovascular Surgery of the Hospital Universitário Pedro Ernesto - UERJ, Rua Boulevard 28 de Setembro, 77 - Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil - Division of Cardiovascular Surgery of the Hospital das Clínicas de Teresópolis Costantino Ottaviano - UNIFESO, Avenida Alberto Torres, 111 - Alto, Teresópolis, RJ, 25964-004, Brazil.

Division of Cardiovascular Surgery of the Hospital Universitário Pedro Ernesto - UERJ, Rua Boulevard 28 de Setembro, 77 - Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil.

出版信息

J Extra Corpor Technol. 2025 Jun;57(2):105-112. doi: 10.1051/ject/2025010. Epub 2025 Jun 16.

Abstract

INTRODUCTION

In cardiopulmonary bypass (CPB), blood circulation is temporarily maintained by an artificial blood-pumping device during cardiac surgery. Worldwide, approximately half of the CPB procedures utilize either centrifugal or roller pumps (Wu P et al. Front Physiol 12, 699891). Centrifugal pumps, while non-occlusive, pose a risk of blood reflux if there is a system failure, which endangers patient safety (Souza MHL, Elias DO. Fundamentos da Circulação Extracorpórea 2006; 186-192). SafeCEC, a one-way valve, offers a potential solution to this risk by preventing arterial line reflux. This pilot study aims to evaluate patient safety by analyzing hemolysis as an evaluation parameter. Plasma free hemoglobin is chosen to measure patient safety with the use of the product, ensuring it does not cause additional hemolysis during extracorporeal circulation.

MATERIALS AND METHODS

After approval by the Ethics Committee, 31 patients undergoing CPB with a centrifugal pump were included in the study. The patients were randomly divided into two groups: group A, where SafeCEC was incorporated into the arterial line, and group B, which used the conventional circuit. Hemolysis was assessed by analyzing plasma free hemoglobin in blood samples collected before CPB, after CPB, and 24 h after weaning from CPB.

RESULTS

This device has been shown to be effective in controlling blood reflux, eliminating the need for arterial line clamps. Analysis of plasma free hemoglobin levels revealed no significant differences between the groups with or without SafeCEC.

CONCLUSION

The SafeCEC one-way valve effectively prevents reflux without contributing to blood damage, as indicated by the absence of significant hemolysis. This pilot study demonstrates that the SafeCEC is both safe and effective for its intended use.

摘要

引言

在体外循环(CPB)中,心脏手术期间通过人工血泵装置暂时维持血液循环。在全球范围内,大约一半的CPB手术使用离心泵或滚压泵(Wu P等人,《生理学前沿》12,699891)。离心泵虽然是非阻塞性的,但如果系统出现故障,则存在血液反流的风险,这会危及患者安全(Souza MHL,Elias DO,《体外循环基础》2006;186 - 192)。SafeCEC是一种单向阀,通过防止动脉管路反流为这一风险提供了潜在的解决方案。这项初步研究旨在通过分析溶血作为评估参数来评估患者安全性。选择血浆游离血红蛋白来衡量使用该产品时的患者安全性,确保其在体外循环期间不会导致额外的溶血。

材料与方法

经伦理委员会批准后,31例使用离心泵进行CPB的患者被纳入研究。患者被随机分为两组:A组,将SafeCEC纳入动脉管路;B组,使用传统回路。通过分析在CPB前、CPB后以及脱离CPB后24小时采集的血样中的血浆游离血红蛋白来评估溶血情况。

结果

已证明该装置在控制血液反流方面有效,无需使用动脉管路夹。血浆游离血红蛋白水平分析显示,使用或未使用SafeCEC的组之间无显著差异。

结论

SafeCEC单向阀可有效防止反流,且不会造成血液损伤,这一点从无明显溶血可以看出。这项初步研究表明,SafeCEC在其预期用途中既安全又有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c2f/12169719/c378676c0deb/ject-57-105-fig1.jpg

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