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A comparison of Cell Saver versus ultrafilter during coronary artery bypass operations
Insights
Two blood conservation techniques, Cell Saver and ultrafiltration, effectively preserved red blood cells during high-volume crystalloid cardioplegia in coronary artery bypass surgery. Both methods showed significant red blood cell conservation compared to a control group.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Biomedical Engineering
Background:
- High-volume crystalloid cardioplegia is used in cardiac surgery.
- Blood conservation strategies are crucial during cardiopulmonary bypass.
- Effective methods are needed to manage cardioplegic effluent and maintain red blood cell mass.
Purpose of the Study:
- To evaluate two blood conservation techniques: Cell Saver and ultrafiltration.
- To compare their efficacy with a retrospective control group.
- To assess their impact on red blood cell conservation and biochemical parameters.
Main Methods:
- Twenty-seven patients undergoing coronary artery bypass surgery were randomized into two groups.
- Group I: Coronary sinus effluent drained into a Cell Saver for red blood cell reinfusion.
- Group II: Coronary sinus effluent absorbed systemically with ultrafiltration of cardiopulmonary bypass circuit.
Main Results:
- Both Cell Saver and ultrafiltration demonstrated significant and equivalent red blood cell conservation compared to the control group.
- The ultrafilter group showed less derangement in prothrombin time.
- The Cell Saver technique provided more complete potassium removal from the cardioplegic solution.
Conclusions:
- Cell Saver and ultrafiltration are effective blood conservation techniques for high-volume crystalloid cardioplegia.
- Ultrafiltration may offer benefits in maintaining coagulation profiles.
- Cell Saver excels in potassium removal, a critical aspect of cardioplegic management.
Abstract:
A study was performed to evaluate two blood conservation techniques that can be used with high-volume crystalloid cardioplegia. Twenty-seven patients undergoing coronary artery bypass with high-volume crystalloid cardioplegia were randomized into two groups: In 12 Group I patients the coronary sinus effluent was drained into a Cell Saver and the recovered, washed red cells were then reinfused. In 15 Group II patients the coronary sinus effluent was absorbed systemically and excess volume was removed from the cardiopulmonary bypass circuit by an ultrafilter. These two groups were compared with a retrospective control group in which the cardioplegic solution had been evacuated from the right atrium and discarded. Both the techniques resulted in significant and equivalent red blood cell conservation compared with the retrospective control group. The ultrafilter was associated with less derangement of prothrombin time. More complete potassium removal was provided by the Cell Saver.