Issue |
J Extra Corpor Technol
Volume 40, Number 1, March 2008
|
|
---|---|---|
Page(s) | 68 - 73 | |
DOI | https://doi.org/10.1051/ject/200840068 | |
Published online | 15 March 2008 |
Abstract
On-Line Autotransfusion Waste Calculator
* Circulation Technology Division, School of Allied Medical Professions, The Ohio State University, Columbus, Ohio
† Global Blood Resources LLC, Somers, Connecticut
Address correspondence to: Jeffrey B. Riley, MHPE, CCT, Cardiovascular Perfusion Department, Mayo Clinic MB1–735, Saint Mary’s Hospital, 1216 Second Street, SW, Rochester, MN 55902. E-mail: riley.jeffrey@mayo.edu
Cell concentrating and washing techniques are widely accepted and believed to be beneficial to cardiac surgery patients. During cell processing, platelets, proteins, and clotting factors are wasted as the plasma is washed away by saline. Beneficial and costly plasma constituents are sacrificed for the sake of removing potentially harmful drugs, debris, and naturally activated cells and chemical mediators. An interactive Microsoft Excel spreadsheet was designed to input patient and autotransfusion system (ATS) reservoir blood values, processed centrifugal bowl data, and hospital allogeneic blood product concentration and cost information. The spreadsheet calculates the number of wasted platelets, grams of protein, and milligrams of fibrinogen. The calculator further estimates the number of units and cost of allogeneic blood products needed to replace the wasted blood components. The simulation allows for variable levels of platelet activation and protein removal during centrifugal cell processing. Specific case scenarios may be simulated with the calculator. If a known volume of residual extracorporeal circuit blood with a known hematocrit, platelet count, and protein concentration is diverted to the ATS reservoir to be processed and washed after bypass, the number of units of fresh frozen plasma, platelet packs, and albumin concentrate needed to replace the wasted proteins and platelets may be calculated. When typical end-bypass patient and blood bank product values are input, the cost to replace the wasted blood components in 1550 mL of residual circuit blood with allogeneic blood products is about US $2097. There are risks and costs associated with replacing the platelets, proteins, and clotting factors wasted during cell washing compared with other techniques such as whole blood ultrafiltration.
Key words: cell processor / autotransfusion / cell washing / hemofiltration / ultrafiltration / Internet / ethics / blood salvaging / blood management
© 2008 AMSECT
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