TITLE

Haemolysis during cardiopulmonary bypass: how to reduce the free haemoglobin by managing the suctioned blood separately

AUTHOR(S)
Pierangeli, A.; Masieri, V.; Bruzzi, F.; de Toni, E.; Grillone, G.; Boni, P.; Delnevo, A.
PUB. DATE
November 2001
SOURCE
Perfusion;Nov2001, Vol. 16 Issue 6, p519
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
During cardiopulmonary bypass (CPB) the collection of the patient's blood from the operating area is of fundamental importance. This blood is collected in the cardiotomy reservoir using field suckers and can be managed in different ways. It can be filtered in the cardiotomy reservoir and redirected to the venous reservoir, then oxygenated and returned to the patient, or it can be managed separately: collected in the cardiotomy reservoir, treated at the end of the operation and only after this, returned to the patient. The aim of this study is to determine in vivo the effect of a separate management of the suction blood from the operative field, using the Avant D903 oxygenator (Dideco, Mirandola, Italy). Twenty-one patients undergoing coronary artery bypass graft surgery with CPB were selected and put into two groups at random. In the control group (n = 10) the suction blood in the cardiotomy reservoir was filtered and immediately redirected into the venous reservoir, oxygenated and returned to the patient. In the study group (n = 11) the suctioned blood was collected in the D903 Avant's (Dideco) cardiotomy reservoir and returned to the patient only after having been washed at the end of the operation, using a Compact Advanced (Dideco), as required. Clinical data demonstrated that while in the study group it was possible to keep the free plasma haemoglobin (FPH) concentrations the same as at the beginning, in the control group there was a significant increase in FPH from 5.063.5 mg/dl (baseline) to 37616.7 mg/dl (120 min after CPB).
ACCESSION #
5529010

 

Related Articles

  • Arch repair with unilateral antegrade cerebral perfusion Küçüker, Şeref A.; Özatik, Mehmet Ali; Sarıtaş, Ahmet; Taşdemir, Oğuz // European Journal of Cardio-Thoracic Surgery;Apr2005, Vol. 27 Issue 4, p638 

    Abstract: Objective: Several antegrade cerebral perfusion techniques with differing neurological outcomes are employed for aortic arch repair. This study demonstrates the clinical results of aortic arch repair with unilateral cerebral perfusion via the right brachial artery. Methods: Between...

  • Vacuum-assisted drainage in cardiopulmonary bypass: advantages and disadvantages. de Carvalho Filho, Élio Barreto; de Lima Marson, Fernando Augusto; Gomes da Costa, Loredana Nilkenes; Antunes, Nilson // Brazilian Journal of Cardiovascular Surgery;apr-jun2014, Vol. 29 Issue 2, p266 

    Systematic review of vacuum assisted drainage in cardiopulmonary bypass, demonstrating its advantages and disadvantages, by case reports and evidence about its effects on microcirculation. We conducted a systematic search on the period 1997-2012, in the databases PubMed, Medline, Lilacs and...

  • Clinical evaluation of setting pump occlusion by the dynamic method: effect on flow. Mongero, L.B.; Beck, J.R.; Orr, T.W.; Kroslowitz, R.M.; Lee-Sensiba, K.; Oz, M.C. // Perfusion;1998, Vol. 13 Issue 5, p360 

    Pump manufacturers recommend setting roller pump occlusion such that the level of a 100 cm column of crystalloid drops 2.5 cm/min (Sarns?, 8000 Modular Perfusion System, operator's manual, roller pump software version 2.3L. May 1993; 2.12.14). Though this almost occlusive setting ensures...

  • Haemolysis during cardiopulmonary bypass: update. Wright, G. // Perfusion;Sep2001, Vol. 16 Issue 5, p345 

    Monitors and measures hemolysis during cardiopulmonary bypass (CPB). Causes of hemolysis during CPB; Blood cell trauma caused by the involvement of air entrainment; Harmful effects of cardiotomy suction.

  • Excessive negative venous line pressures and increased arterial air bubble counts during miniaturized cardiopulmonary bypass: an experimental study comparing miniaturized with conventional perfusion systems. Aboud, Anas; Liebing, Kai; Börgermann, Jochen; Ensminger, Stephan; Zittermann, Armin; Renner, Andre; Hakim-Meibodi, Kavous; Gummert, Jan // European Journal of Cardio-Thoracic Surgery;Jan2014, Vol. 45 Issue 1, p69 

    OBJECTIVES Miniaturized cardiopulmonary bypass (MCPB) is increasingly used in cardiac surgery, because it can lower clinically significant complications such as systemic inflammatory response, haemolysis and high transfusion requirements. A limitation of MCPB is the risk of excessive negative...

  • Inhibition of Endothelium-Dependent Relaxation by Free Hemoglobin in the Human Internal Thoracic Artery. Spyt, Thomas J.; Blake, Karen L.; Watt, Pamela A. C.; Thurston, Herbert // Vascular Surgery;Jan/Feb1994, Vol. 28 Issue 1, p1 

    Hemolysis and postoperative hypertension are well recognized complications of cardiopulmonary bypass (CPB). The rise in the concentration of total and free hemoglobin is directly related to the duration of CPB. It is well established that free hemoglobin binds and inactivates endothelium-derived...

  • Cardiopulmonary bypass with physiological flow and pressure curves: pulse is unnecessary! Voss, Bernhard; Krane, Markus; Jung, Christoph; Brockmann, Gernot; Braun, Siegmund; Günther, Thomas; Lange, Rüdiger; Bauernschmitt, Robert // European Journal of Cardio-Thoracic Surgery;Jan2010, Vol. 37 Issue 1, p223 

    Abstract: Objective: Advocates of pulsatile flow postulate that the flow pattern during extracorporeal circulation (ECC) should be similar to the physiological one. However, the waveforms generated by clinically used pulsatile pumps are by far different from the physiological ones. Therefore, we...

  • The Risk of Performing Cardiopulmonary Bypass in Malaria Patients. Moutaouekkil, El Mehdi; Drissi, Mohamed; Houssa, Mahdi Ait; Boulahya, Abdelletif; El Kirat, Abdelmajid // Texas Heart Institute Journal;2010, Vol. 37 Issue 2, p213 

    The effects of cardiopulmonary bypass on patients who have active or dormant malaria are unknown. What is known is that malaria-induced hemolysis can be exacerbated by cardiopulmonary bypass. We report 3 cases in which patients with active or dormant malaria underwent openheart surgery. Two of...

  • Hemolysis is associated with acute kidney injury during major aortic surgery. Windsant, Iris C. Vermeulen; Snoeijs, Maarten G.; Hanssen, Sebastiaan J.; Altintas, Sibel; Heijmans, John H.; Koeppel, Thomas A.; Schurink, Geert Willem H.; Buurman, Wim A.; Jacobs, Michael J. // Kidney International;May2010, Vol. 77 Issue 10, p913 

    Hemolysis is an inevitable side effect of cardiopulmonary bypass resulting in increased plasma free hemoglobin that may impair tissue perfusion by scavenging nitric oxide. Acute kidney injury after on-pump cardiovascular surgery arises from a number of causes and severely affects patient...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

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

Try another library?
Sign out of this library

Other Topics