How the Hemobag® Works
Whole Blood: The Big Picture
Processing Residual CPB Circuit Whole Blood
How you process this blood changes outcomes
Three Re-infusion Methods:
- Direct Ann Thorac Surg. 1993;56(4);938-43.
- Cell Wash JECT. 1996;28(3);134-9
- Ultrafiltration Perfusion. 2005;20(6);343-9
Fluid shifts in microcirculation, COP, lymphatics and organ edema are the “New Frontier” for improving patient outcomes by perfusionists in cardiac surgery, along with hemostasis when dealing with diluted blood, plasma volume contraction and pushing renal function for fluid balance.
There is increasing evidence that albumin levels possess additional effects on organ perfusion, microcirculation, tissue oxygenation, inflammation, endothelial activation, capillary leakage, and tissue edema that are well beyond just the volume expanding/replacing properties.
Fluid overload is an independent predictor of mortality in cardiac surgical patients as well as an indirect trigger for transfusions, which carries its own evidence for morbidity and mortality.
Final Infusion Volume Contents
NOTE: 90 percent confidences limits for pre-protamine infusion volumes and blood component values. (Proc Amer Soc Extra Corpor Technol. 2006)
Example of typical results when the ECC is returned with the Hemobag®
What is the next evolution of blood processing for the Post-CPB Circuit in CV surgery?
Typically the total 24 hour chest tube drainage is 100-300 mL of serous fluid.
Patients are discharged with no blood products and no complications
Ultrafiltration has the benefit of concentrating whole blood quickly and easily saving all the plasma as well as the RBCs.
SO HOW CAN WE MAKE IT REALLY EASY?
Finished product concentrated in 8-10 minutes
We’ll help make it easy for you to become
the leader at your program!
Global Blood Resources
The next evolutionary step in processing post-CPB circuit whole blood for improved patient outcomes!
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- Surgenor SD, et al; Northern New England Cardiovascular Disease Study Group. The Association of Perioperative Red Blood Cell Transfusions and Decreased Long-term Survival After Cardiac Surgery. Anesth Analg 2009 Jun; 180(6):1741-6.
- Bernard AC, Davenport DL, Chang PK, Vaughan TB, Zwischenberger JB. Intraoperative Transfusion of 1 U to 2 U Packed Red Blood Cells is Associated with Increase 30-day Mortality, Surgical-site Infection, Pneumonia, and Sepsis in General Surgery Patients. J Am Coll Surg 2009 May; 208(5);931-7, 937.e1-2; discussion 938-9. Epub 2009 Mar 26.
- Mathew JP, er al. Effects of Extreme Hemodilution During Cardiac Surgery on Cognitive Function in the Elderly. Anesthesiology. 2007 Oct; 107(4):577-84.
- Koch CG, et al. Duration of Red-cell Storage and Complications After Cardiac Surgery. N Engle J Med 2008 Mar 20;358(12):1229-39.
- Murphy GJ, Reeves BC, Rogers CA, Rizvi SI, Culliford L, Angelini GD. Increased Mortality, Postoperative Morbidity, and Cost After Red Blood Cell Transfusion in Patients Having Cardiac Surgery. Circulation 2007 Nov 12; [Epub ahead of Print].
- Hirleman E, Larson DF. Cardiopulmonary Bypass and Edema: Physiology and Pathophysiology. Perfusion. 2008 Nov;23(6):311-22.
- Campbell JA, Holt DW, Shostrom VK, Durham SJ. Influence of Intraoperative Fluid Volume on Cardiopulmonary Bypass Hematocrit and Blood Transfusions in Coronary Artery Bypass Surgery. J Extra Corpor Technol 208 Jun;40(2):99-108.
- Rubens FD, Boodhwani M, Mesana T, Wozny D, Wells G, Nathan HJ; Cardiotomy Investigators. The Cardiotomy Trial: A Randomized, Douple-blind Study to Assess the Effect of Processing of Shed Blood During Cardiopulmonary Bypass on Transfusion and Neurocognitive Function. Circulation 2007 Sep 11;116(11 Suppl):189-97.
- Boodhwani M, Williams K, Babaev A, Gill G, Saleem N, Rubens FD. Ultrafiltration Reduces Blood Transfusions Following Cardiac Surgery: A Meta-Analysis. Eur J Cardiothorac Surf. 2006 Dec; 30(6):892-7. Epub 2006 Oct 13.
- Murphy GJ. Does Blood Transfusion Harm Cardiac Surgery Patients? BMC Med. 2009 Jul 31;7;38.
- Blood Transfusion From Another Person Doubles Infection Risk After CABG Surgery. BMJ 2009;339:b3147.
- Chappell D, Jacob M, Hofmann-Kiefer K, Conzen P, Rehm M. A Rational Approach to Perioperative Fluid Management. Anesthesiology.2008 Oct;109(4):723-40.
- Watson GA, Sperry JL, Rosengart MR, Minei JP, Harbrecht BG, Moore EE, Cuschieri J, Maier RV, Billiar TR, Peitzman AB; Inflammation and Host Response to Injury Investigators. Fresh Frozen Plasma is Independently Associated With a Higher Risk of Multiple Organ Failure and Acute Respiratory Distress Syndrome. J Trauma. 2009 Aug;67(2):221-7; discussion 228-30.
- Benson AB, Moss M, Silliman CC. Transfusion-related Acute Lung Injury (TRALI): Clinical Review with Emphasis on the Critically Ill. Br J Haematol. 2009 Aug 5. [Epub ahead of print]