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The Annals of Thoracic Surgery, Vol 51, 747-753, Copyright © 1991 by The Society of Thoracic Surgeons

ARTICLES

Six different hemofiltration devices for blood conservation in cardiac surgery

J Boldt, B Zickmann, B Fedderson, C Herold, F Dapper and G Hempelmann
Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig- University, Giessen, Federal Republic of Germany.

Hemofiltration devices and the Cell Saver are the most often used techniques to reduce homologous blood requirements in cardiac surgery. In a controlled, randomized study, 105 patients underwent elective aortocoronary bypass grafting. Six different hemofilters (HF-80, HFT 14, CPB 7000, Cobe 1200, UF-205, BC-140) were tested and compared with the Cell Saver (Cell Saver 4) for blood concentration during and after cardiopulmonary bypass. Efficacy, practicality, and laboratory indices including coagulation variables were documented through the morning of the first postoperative day. The HF-80 and UF-205 were the most effective devices for blood concentration. At the end of the operation, the number of platelets was least reduced in these two groups (HF-80, - 7%; UF-205, -6%). Moreover, both devices had a significantly higher filtration rate than the other hemofilters. Use of the Cell Saver resulted in the lowest values in coagulation variables (AT-III, fibrinogen, number of platelets) and the most pronounced deterioration in protein homeostasis (colloid osmotic pressure, albumin). In this group, the AT-III concentration was reduced until the morning of the first postoperative day. No negative effects were seen in regard to hemofiltration (free hemoglobin and polymorphonuclear elastase; the Cell Saver group had similar values for these variables). We conclude that blood salvage with hemofiltration devices is superior to that with the Cell Saver. There were, however, significant differences among the hemofilters. The HF-80 and UF-205 were the most effective devices in this study.

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