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The Annals of Thoracic Surgery, Vol 51, 747-753, Copyright © 1991 by The Society of Thoracic Surgeons
J Boldt, B Zickmann, B Fedderson, C Herold, F Dapper and G Hempelmann
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.
ARTICLES
Six different hemofiltration devices for blood conservation in cardiac surgery
Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig- University, Giessen, Federal Republic of Germany.
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