Efficacy of the RemoweLL cardiotomy reservoir for fat and leucocyte removal from shed mediastinal blood: a randomized controlled trial

Lagny, Marc-Gilbert; Gothot, André; Hans, Grégory; Koch, Jean-Noël; Blaffart, Francine; Hella, Dominique; Donneau, Anne‐Françoise; Roediger, Laurence; Lecut, Christelle; Pincemaïl, Joël; Cheramy-Bien, Jean-Paul; Defraigne, Jean-Olivier

doi:10.1177/0267659116649427

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…However, some studies found a decrease in fat removal, 75,77 whereas others failed to replicate previous findings. 76 This difference is probably due to a different measurement method. More studies with clinical end points are needed to establish a benefit from this device.…”

Section: Reservoirsmentioning

confidence: 99%

2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery

Kunst

Milojevic

Boer

et al. 2019

British Journal of Anaesthesia

129

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Special Article responsible in the event of any contradiction, discrepancy and/or ambiguity between the EACTS, EACTA and EBCP Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the EACTS, EACTA and EBCP Guidelines fully into account when exercising their clinical judgement as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies; however, the EACTS, EACTA and EBCP Guidelines do not, in any way whatsoever, override the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and, where appropriate and/or necessary, in consultation with that patient and the patient's care provider. Nor do the EACTS, EACTA and EBCP Guidelines exempt health professionals from giving full and careful consideration to the relevant official, updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient's case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription. The article has been co-published with permission in the British Journal of Anaesthesia, the European Journal of Cardio-Thoracic Surgery and the Interactive CardioVascular and Thoracic Surgery.

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Section: Reservoirsmentioning

confidence: 99%

2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery

Kunst

Milojevic

Boer

et al. 2019

British Journal of Anaesthesia

129

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“…This result is similar to the findings of Dell’Amore and co-authors 9 and to other studies recently published. 11 In the same way the release of pro-inflammatory cytokines is significantly reduced in Group B (RemoweLL) in contrast with Group A. Unlike the above-mentioned studies we did not register differences between haematocrit, platelets and cholesterol levels; even the release of myocardial necrosis markers looks to be similar.…”

Section: Discussionmentioning

confidence: 40%

“…All continuous data are expressed as mean ± SD. A sample size calculation was carried out to identify the minimum number of patients to be included in each group: on the basis of the studies by Dell’Amore 9 and Lagny and colleagues 11 we would expect a ratio between the mean values relative to the two groups at Time 1 and Time 2 of about 1.25 with a coefficient of variation of 0.25. A two-sided, two-sample t -test with group sample sizes of 21 and 21 achieves 80% power to detect a ratio of 1.250 when the ratio under the null hypothesis is 1.000.…”

Section: Methodsmentioning

confidence: 99%

“…Some clinical researches on the use of this device are available in the international literature but they, on the whole, concern the application of RemoweLL to coronary artery bypass grafting interventions. [9][10][11] The aim of the present study was to assess the efficacy of the RemoweLL reservoir (Eurosets, Italy) to remove fat particles and leucocytes from shed mediastinal blood during aortic valve replacement interventions.…”

Section: Introductionmentioning

confidence: 99%

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The use of RemoweLL oxygenator-integrated device in the prevention of the complications related to aortic valve surgery in the elderly patient: Preliminary results

Molardi

Chicco

Carino

et al. 2018

Eur J Prev Cardiolog

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Background The effects of fat microembolization due to cardiopulmonary bypass are well known in cardiac surgery. Our aim is to evaluate the use of the RemoweLL device (Eurosets, Medolla, Italy) during elective aortic valve replacement in elderly patients (>70 years old) to rate its biochemical and clinical effects. The RemoweLL device is an oxygenator-integrated reservoir which combines two strategies for fat emboli and leucocytes removal: filtration and supernatant elimination. Methods Forty-four elderly patients were enrolled and assigned randomly to a Group A (standard device) and a Group B (RemoweLL). Biochemical effects were evaluated by blood samples, which were tested for white blood cells, neutrophils, protein SP-100 and interleukin 6 besides standard lab tests. Our clinical endpoints were any type of neurological, cardiac, respiratory, gastrointestinal or renal complications, and length of stay in the intensive care unit. Statistical analysis was carried out with chi square test for non-parametric data; t test and analysis of variance for repeated measures were used for parametric data. Results Group B showed lower levels of white blood cells, neutrophils, interleukin 6 and protein SP-100 immediately and 24 hours after the operation. Group B also showed a lower amount of neurocognitive type II dysfunction even if the length of stay in the ICU did not change. Conclusions The RemoweLL system is safe and effective in reducing inflammatory response to cardiopulmonary bypass and it could be a useful tool in minimizing negative effects of cardiopulmonary bypass; however, it does not seem to have any effect on elderly patients' hospital stay.

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“…As a result, the panel recommends a closed venous reservoir for selected patients to lessen the inflammatory response and enhance biocompatibility. Additionally, considering a separate cardiotomy reservoir may help reduce the adverse effects of shed mediastinal blood, such as fat removal and decreased circulating leukocytes, regardless of the reservoir type [32,33].…”

Section: Reservoirsmentioning

confidence: 99%

Mastering the Best Practices: A Comprehensive Look at the European Guidelines for Cardiopulmonary Bypass in Adult Cardiac Surgery

Milojevic

Milošević

Nikolić³

et al. 2023

JCDD

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The successful outcome of a cardiac surgery procedure is significantly dependent on the management of cardiopulmonary bypass (CPB). Even if a cardiac operation is technically well-conducted, a patient may suffer CPB-related complications that could result in severe comorbidities, reduced quality of life, or even death. However, the role of clinical perfusionists in perioperative patient care, which is critical, is often overlooked. Therefore, the European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Cardiothoracic Anaesthesiology (EACTA), and the European Board of Cardiovascular Perfusion (EBCP) have agreed to develop joint clinical practice guidelines (CPGs) for CPB due to its significant impact on patient care and significant variations in practice patterns between countries. The European guidelines, based on the EACTS standardized framework for the development of CPGs, cover the entire spectrum of CPB management in adult cardiac surgery. This includes training and education of clinical perfusionists, machine hardware, disposables, preparation for initiation of CPB, a complete set of procedures during CPB to help maintain end-organ function and anticoagulation, weaning from CPB, and the gaps in evidence and future research directions. This comprehensive coverage ensures that all aspects of CPB management are addressed, providing clinicians with a standardized approach to CPB management based on the latest evidence and best practices. To ensure better integration of these evidence-based recommendations into daily practice, this review aims to provide a general understanding of guideline development and an overview of essential treatment recommendations for CPB management.

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Efficacy of the RemoweLL cardiotomy reservoir for fat and leucocyte removal from shed mediastinal blood: a randomized controlled trial

Abstract: The RemoweLL filter more effectively removed leucocytes from SMB than the Admiral. It offered no advantage in terms of lipid particle clearance.

Cited by 6 publications

References 19 publications

2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery

2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery

The use of RemoweLL oxygenator-integrated device in the prevention of the complications related to aortic valve surgery in the elderly patient: Preliminary results

Mastering the Best Practices: A Comprehensive Look at the European Guidelines for Cardiopulmonary Bypass in Adult Cardiac Surgery

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