Pump blood processing, salvage and re-transfusion improves hemoglobin levels after coronary artery bypass grafting, but affects coagulative and fibrinolytic systems
| Autor: | Piero Guida, Giuseppe Scrascia, D Nanna, L de Luca Tupputi Schinosa, Ruggiero Rociola, Domenico Paparella, Giovanni Rubino, Crescenzia Rotunno |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Blood transfusion medicine.medical_treatment Blood Loss Surgical law.invention Blood Transfusion Autologous Hemoglobins Blood product law Plasminogen Activator Inhibitor 1 Fibrinolysis medicine Cardiopulmonary bypass Humans Radiology Nuclear Medicine and imaging Fibrinolysin Coronary Artery Bypass Aged Advanced and Specialized Nursing Interleukin-6 Operative Blood Salvage business.industry General Medicine Heparin Middle Aged Antifibrinolytic Agents Red blood cell medicine.anatomical_structure Anesthesia Female Erythrocyte Transfusion Cardiology and Cardiovascular Medicine business Safety Research Plasminogen activator medicine.drug Artery |
| Zdroj: | Perfusion. 27:270-277 |
| ISSN: | 1477-111X 0267-6591 |
| DOI: | 10.1177/0267659112442236 |
| Popis: | Cell saving systems are commonly used during cardiac operations to improve hemoglobin levels and to reduce blood product requirements. We analyzed the effects of residual pump blood salvage through a cell saver on coagulation and fibrinolysis activation and on postoperative hemoglobin levels. Thirty-four elective coronary artery bypass graft (CABG) patients were randomized. In 17 patients, residual cardiopulmonary bypass (CPB) circuit blood was transfused after the cell saving procedure (cell salvage group). In the other 17 patients, residual CPB circuit blood was discarded (control group). Activation of the coagulative, fibrinolytic and inflammatory systems was evaluated pre-operatively (Pre), 2 hours after the termination of CPB (T0) and 24 hours postoperatively (T1), measuring prothrombin fragment 1.2 (PF 1.2), plasmin-anti-plasmin (PAP), plasminogen activator inhibitor-1 (PAI-1) and interleukin-6 (IL-6). The cell salvage group of patients had a significant improvement in hemoglobin levels after processed blood infusion (2.7 ± 1.7 g/dL vs 1.2 ± 1.1 g/dL; p=0.003). PF1.2 levels were significantly higher after infusion (T0: 1175 ± 770 pmol/L vs 730 ± 237 pmol/L; p=0.037; T1: 331 ± 235 pmol/L vs 174 ± 134 pmol/L; p=0.026). Also, PAP levels were higher in the cell salvage group, although not significantly (T0: 253 ± 251 ng/mL vs 168 ± 96 ng/mL; p: NS; T1: 95 ± 60 ng/mL vs 53 ± 32 ng/mL; p: NS). No differences were found for PAI-1, IL-6, heparin levels or for red blood cell (RBC) transfusions. The cell salvage group of patients had increased chest tube drainage (749 ± 320 vs 592 ± 264; p: NS) and fresh frozen plasma transfusion rate (5 (29%) pts vs 0 pts; p |
| Databáze: | OpenAIRE |
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