Immediate centrifugation of oxygenator contents after cardiopulmonary bypass

Moran, John M.; Babka, Ronald; Silberman, Simone; Rice, Pamela L.; Pifarré, Roque; Sullivan, Henry J.; Montoya, Alvaro

doi:10.1016/s0022-5223(19)41081-7

Cited by 70 publications

(18 citation statements)

References 9 publications

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“…Our results for PCV are similar to that of others (Watson‐Williams, 1974; Moran et al ., 1978; Ottesen & Frøysaker, 1982; McShane et al ., 1987; Boldt et al ., 1989; Williams et al ., 1997), although one report gives a much lower PCV (O'Hara et al ., 1983). Haemoglobin values are also in agreement with earlier work (Ottesen & Frøysaker, 1982; McShane et al ., 1987; Boldt et al ., 1989), as is free haemoglobin (Moran et al ., 1978; O'Hara et al ., 1983; Boldt et al ., 1989).…”

Section: Discussionsupporting

confidence: 92%

“…The platelet counts we found are similar to the previous work (Yawn & Bull, 1988; Boldt et al ., 1989; Reents et al ., 1999), although lower counts have also been found (Ottesen & Frøysaker, 1982; McShane et al ., 1987). The rise of platelet numbers after cell washing has also reported by others (Moran et al ., 1978). That platelet counts are lower than in bank blood has also been found earlier (O'Hara et al ., 1983).…”

Section: Discussionsupporting

confidence: 82%

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Study of five cell salvage machines in coronary artery surgery

Burman¹,

Westlake²,

Davidson³

et al. 2002

Transfusion Medicine

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We evaluated the effectiveness, ease of use and safety of five machines for blood salvage during coronary artery surgery. All were equally effective in concentrating red cells. We measured haemoglobin, packed cell volume, free haemoglobin, white cells, neutrophil elastase, platelets, thrombin-antithrombin complex (TAT), prothrombin activation peptide F1.2, fibrin degradation product (d-dimers), tissue plasminogen activator (tPA) and heparin in wound blood, in washed cell suspensions and in a unit of bank blood prepared for each patient. All machines were equally safe and easy to use and were equally effective in removing heparin and the physiological components measured. There were no adverse effects on patients. Clotting factors are severely depleted both in salvaged blood, even before washing, and in bank blood. Cell savers are a valuable adjunct to coronary artery surgery, but careful monitoring of coagulation is required when the volumes of either bank blood or salvaged blood are large.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 82%

Study of five cell salvage machines in coronary artery surgery

Burman¹,

Westlake²,

Davidson³

et al. 2002

Transfusion Medicine

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“…Today, cell saving devices can process quickly even small amounts of blood, require small priming volumes, continuously return high quality blood during and after surgery, and can collect blood not only during heparinization, but also when there is no heparin effect (eg, during internal mammary artery preparation). Several reports document the safety of the cell saver and support its routine use in cardiac surgery as a means to reduce blood transfusion [Moran 1978;Cordell 1981;Winton 1982;Keeling 1983;Mayer 1985;Hall 1990;Lee 1997;Tempe 2001], and intraoperative autologous blood donation combined with cell saver use decreases transfusion requirements in small-size patients (mean body weight of 45 kg) [Tempe 1996]. In a recent RCT, patients scheduled for CABG were randomized to autotransfusion (receiving autotransfused washed blood from intraoperative cell salvage and postoperative mediastinal fl uid cell salvage, n = 98), or control (receiving stored homologous blood only, n = 102).…”

Section: Red Cell Savingmentioning

confidence: 99%

“…Autologous blood cell salvage is used routinely in many parts of the world in cardiac [ASA Task Force on Perioperative Blood Transfusion and Adjuvant Therapies 2006] and other high-risk operations [Goodnough 2003]. We studied 3 reviews [Goodnough 2003; ASA Task Force on Perioperative Blood Transfusion and Adjuvant Therapies 2006; Ferraris 2007] and 17 clinical trials [Moran 1978;Thurer 1979;Cordell 1981;Winton 1982;Keeling 1983;Mayer 1985;Dietrich 1989;Hall 1990;Merville 1991;Despotis 1996;Tempe 1996;Lee 1997;Gray 2001;Tempe 2001;Daane 2003;Svenmarker 2003; (Table 3). Most of the trials are RCTs [Moran 1978;Thurer 1979;Mayer 1985;Dietrich 1989;Merville 1991;Tempe 1996;Tempe 2001;Daane 2003;Svenmarker 2003;.…”

Section: Red Cell Savingmentioning

confidence: 99%

Management of Intraoperative Fluid Balance and Blood Conservation Techniques in Adult Cardiac Surgery

Vretzakis¹,

Kleitsaki²,

Αρέθα³

et al. 2011

HSF

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Blood transfusions are associated with adverse physiologic effects and increased cost, and therefore reduction of blood product use during surgery is a desirable goal for all patients. Cardiac surgery is a major consumer of donor blood products, especially when cardiopulmonary bypass (CPB) is used, because hematocrit drops precipitously during CPB due to blood loss and blood cell dilution. Advanced age, low preoperative red blood cell volume (preoperative anemia or small body size), preoperative antiplatelet or antithrombotic drugs, complex or re-operative procedures or emergency operations, and patient comorbidities were identified as important transfusion risk indicators in a report recently published by the Society of Cardiovascular Anesthesiologists. This report also identified several pre- and intraoperative interventions that may help reduce blood transfusions, including off-pump procedures, preoperative autologous blood donation, normovolemic hemodilution, and routine cell saver use.A multimodal approach to blood conservation, with high-risk patients receiving all available interventions, may help preserve vital organ perfusion and reduce blood product utilization. In addition, because positive intravenous fluid balance is a significant factor affecting hemodilution during cardiac surgery, especially when CPB is used, strategies aimed at limiting intraoperative fluid balance positiveness may also lead to reduced blood product utilization.This review discusses currently available techniques that can be used intraoperatively in an attempt to avoid or minimize fluid balance positiveness, to preserve the patient's own red blood cells, and to decrease blood product utilization during cardiac surgery.

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“…In the first, blood remaining in the reservoir of a pump-oxygenator used for cardiopulmonary bypass is returned to the patient. It has been emphasized that washing the salvaged red cells with saline prior to reinfusion is beneficial by reducing or eliminating extraneous cellular debris [42] and heparin [43]. Washing oxygenator reservoir cells salvaged in this manner is practiced widely.…”

Section: Forms Of Autologous Transfusion Practicementioning

confidence: 99%