Proceedings

A Comparison of Two Methods of Post-Bypass Hemoconcentration

From the Extracorporeal Circulation Technology Program and the Division of Thoracic Surgery, Medical University of South Carolina, Charleston, South Carolina 29425

^* Address reprint requests to Ms. Brickley, 171 Ashley Avenue, Charleston, South Carolina 29425

Abstract

Post-pump hemoconcentration is currently accomplished by centrifugation and saline washing, the product being packed red cells suspended in saline. This study was designed to compare centrifugation with ultrafiltration by an artificial kidney, the product of this method being whole blood.

Sixteen adult patients undergoing cardiopulmonary bypass were assigned to one of two groups. Hemoconcentration was achieved in Group I with the Cell Saver and with an artificial kidney in Group II. Coagulation data, plasma proteins, colloid osmotic pressure, hematocrit, platelet count, plasma free hemoglobin, and fibrinogen levels were collected and compared at various times during each case.

The mean total protein concentration of the ultrafiltered blood (8.01 ± 1.31 g/dl) was significantly greater than that of the Cell Saver blood (0.29 ± 0.29 g/dl, p < .01). Also, the mean total protein concentration in the discard was significantly greater in the Cell Saver group (1.69 ± 0.56 g/dl) than the artificial kidney group (0.09 ± 0.14, p < .01). There were no significant differences between the two groups in the other parameters compared.

While the artificial kidney was quite effective in conserving the plasma proteins during hemoconcentration, no additional advantages were demonstrated during this study.