Related Experiment Videos
Blood conservation in cardiac operations. Cell separation versus hemofiltration
J Boldt1, D Kling, B von Bormann
1Department of Anesthesiology and Intensive Care Medicine, Liebig-University, Giessen, Federal Republic of Germany.
The Journal of Thoracic and Cardiovascular Surgery
|June 1, 1989
Summary
Hemofiltration is a superior method for hemoconcentration during cardiac surgery compared to centrifugation. It conserves blood effectively with fewer complications and lower costs, making it the preferred choice for blood conservation.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Hematology
Background:
- Extracorporeal circulation (ECC) in cardiac surgery leads to blood dilution.
- Hemoconcentration is crucial for managing diluted blood during and after ECC.
- Centrifugation and hemofiltration are two methods for hemoconcentration.
Purpose of the Study:
- To compare the effectiveness of centrifugation versus hemofiltration for hemoconcentration.
- To evaluate the quality of concentrated blood and patient reactions post-retransfusion.
- To determine the optimal hemoconcentration method for blood conservation in cardiac operations.
Main Methods:
- Investigated hemoconcentration using centrifugation (n=20) or hemofiltration (n=20) in 40 patients undergoing aorta-coronary bypass grafting.
- Assessed blood quality, coagulation parameters (heparin, fibrinogen, antithrombin III, platelets), free hemoglobin, and elastase levels.
- Monitored patient outcomes, including postoperative bleeding and organ function.
Main Results:
- Hemofiltration was faster and easier to perform than centrifugation.
- No significant differences in key coagulation parameters or platelet counts were observed between groups.
- Coagulation parameters normalized more quickly after hemofiltration; less derangement in colloid osmotic pressure and coagulation was noted.
- Hemofiltration avoided plasma fraction loss, a disadvantage of centrifugation.
- No severe bleeding or adverse organ function effects were reported for either method.
Conclusions:
- Both centrifugation and hemofiltration are effective for hemoconcentration during ECC.
- Hemofiltration offers advantages over centrifugation, including faster processing, avoidance of plasma loss, and less impact on coagulation and colloid osmotic pressure.
- Hemofiltration is a cost-effective method and the preferred choice for blood conservation in cardiac operations, especially when large volumes of cardioplegic solution are used.