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Related Experiment Videos

[Alternative mechanical autotransfusion. Hemofiltration vs. hemoseparation].

B von Bormann1, B Weidler, R Holleufer

  • 1Abteilung Anästhesiologie und Operative Intensivmedizin, St. Johannes-Hospital, Duisburg-Hamborn.

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
|February 1, 1992
PubMed
Summary

Haemofiltration is a viable alternative for concentrating shed blood during vascular surgery, preserving vital plasma proteins. This method offers a quicker process than cell separation, aiding intraoperative autotransfusion.

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Area of Science:

  • Cardiovascular Surgery
  • Blood Transfusion
  • Biomedical Engineering

Background:

  • Intraoperative blood loss during vascular surgery necessitates effective blood management strategies.
  • Autotransfusion techniques aim to reinfuse the patient's own blood, reducing the need for allogeneic transfusions.
  • Concentrating shed blood requires methods that maintain blood product quality.

Purpose of the Study:

  • To investigate the effects of haemoconcentration on shed blood quality using centrifugation (cell separation) versus haemofiltration.
  • To compare the efficiency and blood product quality resulting from these two haemoconcentration techniques.
  • To evaluate the potential of haemofiltration as an alternative for intraoperative autotransfusion.

Main Methods:

  • An in-vitro study comparing centrifugation and haemofiltration for concentrating shed blood from vascular surgery patients (n=10 each).

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  • Measurement of various blood parameters in patients, shed blood, and post-concentration samples.
  • Assessment of coagulation activation, free hemoglobin, elastase, thrombocytes, plasma proteins, and hematocrit.

    • Main Results:

    • Haemofiltration was faster (1.2 minutes) than cell separation (3.0 minutes).
    • Cell separation removed thrombocytes, elastase, free hemoglobin, and plasma proteins (including antithrombin III and fibrinogen), with higher red cell concentration (hct 55% vs 35%).
    • Haemofiltration preserved plasma proteins and resulted in tolerable heparin levels, showing potential for autotransfusion without needing fresh frozen plasma.

    Conclusions:

    • Haemofiltration is a promising alternative for intraoperative autotransfusion due to its speed and preservation of essential plasma proteins.
    • This method avoids the need for additional fresh frozen plasma, particularly beneficial in cases of significant blood loss.
    • Both procedures were safe, with no activated clotting factors observed post-procedure.