A new practical technique to reduce allogeneic blood exposure and hospital costs while preserving clotting factors after cardiopulmonary bypass: the Hemobag®

Samolyk, Keith A.; Beckmann, Scott R.; Bissinger, Randall C.
November 2005
Perfusion;Nov2005, Vol. 20 Issue 6, p343
Academic Journal
Recent data independently linking allogeneic blood use to increased morbidity and mortality after cardiopulmonary bypass (CPB) warrants the study of new methods to employ unique and familiar technology to reduce allogeneic blood exposure. The Hemobag® allows the open-heart team to concentrate residual CPB circuit contents and return a high volume of autologous clotting factors and blood cells to the patient. Fifty patients from all candidates were arbitrarily selected to receive the Hemobag® (HB) therapy. A retrospective control group of 50 non-Hemobag® (NHB) patients were matched to the HB group patient-by-patient for comparison according to surgeon, type of procedure, age, body surface area (BSA), body weight and CPB time. Many efforts to conserve blood (Cell Saver® and ANH) were employed in both groups. Post-CPB cell washing of circuit contents was additionally employed in the control group. There were no significant differences between the HB and NHB groups in regard to patient morphology, pre-op cell concentrations, distribution of surgeon or procedures (41% valve, 16% valve/coronary artery bypass graft (CABG), balance CABG), pump and ischemic times and Bayes National Risk scores. The average volume returned to the patient from the HB was 817±198 mL (1 SD). Average processing time was 11 min. The Hemobag® contained an average platelet count of 230±80 K/mm3, fibrinogen concentration of 413±171 mg/dl, total protein of 8.0±2.8 gm/dl, albumin of 4.4±1.2 gm/dl and hematocrit of 43±7%. Factor VII, IX and X levels in three HB contents averaged 259% greater than baseline. Substantial reductions were achieved in both allogeneic blood product avoidance and cost to the hospital with use of the HB. Infusion of the Hemobag® concentrate appears to recover safely substantial proteins, clotting factor and cell concentration for all types of cardiac procedures, maintaining the security of a primed circuit.


Related Articles

  • Effects of protective and conventional mechanical ventilation on pulmonary function and systemic cytokine release after cardiopulmonary bypass. Koner, Ozge; Celebi, Serdar; Balci, Huriye; Cetin, Gurkan; Karaoglu, Kamil; Cakar, Nahit // Intensive Care Medicine;Apr2004, Vol. 30 Issue 4, p620 

    Objective: To evaluate the effects of protective and conventional ventilation with or without positive end-expiratory pressure (PEEP), on systemic tumor necrosis factor-alpha, interleukin-6 levels and pulmonary function during open heart surgery.Design: Prospective,...

  • Comparison of the effects of gelatin and a modern hydroxyethyl starch solution on renal function and inflammatory response in elderly cardiac surgery patients. J. Boldt; Ch. Brosch; K. Röhm; M. Papsdorf; A. Mengistu // BJA: The British Journal of Anaesthesia;Apr2008, Vol. 100 Issue 4, p457 

    Background The effects of hydroxyethylstarch (HES) 130/0.4 6% and gelatin 4% on inflammation, endothelial integrity, and renal function after cardiac surgery were compared. Methods Sixty patients aged >80 yr undergoing cardiac surgery were randomized to receive gelatin (n=30) or HES 130/0.4...

  • Comparison of S100B and NSE Between Cardiac Surgery and Interventional Therapy for Children. Yu Liu; Ying Xu; Da-zhen Li; Yuan Shi; Mao Ye // Pediatric Cardiology;Oct2009, Vol. 30 Issue 7, p893 

    This study aimed to compare the release of S100B and NSE between cardiac surgery and interventional therapy for children and to investigate whether S100B serum concentration correlates with cardiopulmonary bypass in children. For this study, 40 children with congenital heart disease were...

  • Retrospective Study Of Redo Cardiac Surgery In A Single Centre. Karthekeyan, Ranjith B.; Selvaraju M.D., Karthikeyan N.; Ramanathan, Lakshmi; Rakesh, M. G.; Rao, K. G. Suresh; Vakamudi, Mahesh; Balakrishnan, K. R. // Internet Journal of Anesthesiology;2007, Vol. 13 Issue 1, p29 

    Background: An increasing number of patients are being referred to tertiary referral centre for re-do cardiac surgery and will continue to increase. Though it is a sign of improving medical care and better management, it is a challenge for every cardiac anesthesiologist in handling this subset...

  • ULTRASONIC RADIATION FORCE FOR EMBOLI REMOVAL FROM BLOOD. Campbell, C. A.; Hinders, M. K. // AIP Conference Proceedings;2/22/2010, Vol. 1211 Issue 1, p1551 

    In this work we investigate the removal of emboli from cardiopulmonary bypass circuits via acoustic radiation force. Unless removed, emboli can be a significant source of cognitive deficit after cardiac surgery. We have implemented both inviscid linear and viscous non-linear models for radiation...

  • Treatment of accidental hypothermia with cardiopulmonary bypass: a case report. Binnema, R.; van der Wal, A.; Visser, C.; Schepp, R.; Jekel, L.; Schröder, P. // Perfusion;May2008, Vol. 23 Issue 3, p193 

    This case report describes the successful treatment of severe accidental hypothermia of a 40-year-old woman. At arrival in the operating theatre her rectal temperature was 23°C, her nasal temperature 21°C and her periferal temperature 14°C. The patient presented with a severe...

  • Does a reduced glucose intake prevent hyperglycemia in children early after cardiac surgery? a randomized controlled crossover study. I. de Betue, Carlijn T.; A.T. Verbruggen, Sascha C.; Schierbeek, Henk; Chacko, Shaji K.; J.C. Bogers, Ad J.; van Goudoever, Johannes B.; M. Joosten, Koen F. // Critical Care;2012, Vol. 16 Issue 5, p11658 

    Introduction: Hyperglycemia in children after cardiac surgery can be treated with intensive insulin therapy, but hypoglycemia is a potential serious side effect. The aim of this study was to investigate the effects of reducing glucose intake below standard intakes to prevent hyperglycemia, on...

  • Prevention of TNFα-associated myocardial dysfunction resulting from cardiopulmonary bypass and cardioplegic arrest by glucocorticoid treatment Liakopoulos, Oliver J.; Teucher, Nils; Mühlfeld, Christian; Middel, Peter; Heusch, Gerd; Schoendube, Friedrich A.; Dörge, Hilmar // European Journal of Cardio-Thoracic Surgery;Aug2006, Vol. 30 Issue 2, p263 

    Abstract: Objective: Cardiac surgery on cardiopulmonary bypass (CPB) results in progressive myocardial dysfunction, despite unimpaired coronary blood flow, and is associated with increased myocardial tumor necrosis factor-α (TNFα) expression. We investigated whether anti-inflammatory...

  • Factor VIIa treatment of DIC as a clinical manifestation of amniotic fluid embolism in a patient with fetal demise. Kahyaoglu, Inci; Kahyaoglu, Serkan; Mollamahmutoglu, Leyla // Archives of Gynecology & Obstetrics;Jul2009, Vol. 280 Issue 1, p127 

    Introduction: A pregnant patient, with term intrauterine fetal demise, who developed cardiopulmonary arrest during labor, followed by disseminated intravascular coagulation (DIC) secondary to amniotic fluid embolism (AFE) that was treated with Recombinant Factor VIIa, is...


Read the Article

Courtesy of

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics