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Erschienen in: Heart and Vessels 8/2019

27.02.2019 | Original Article

Cell salvage processing of residual cardiopulmonary bypass volume in minimally invasive cardiac surgery

verfasst von: Ryosuke Muraki, Toshinori Totsugawa, Kazuyuki Nagata, Kosuke Nakajima, Tomoya Oshita, Masahisa Arimichi, Hidenori Yoshitaka, Taichi Sakaguchi

Erschienen in: Heart and Vessels | Ausgabe 8/2019

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Abstract

Several reports demonstrated positive effects of processing residual cardiopulmonary bypass volume using a cell salvage device in conventional open heart surgery via sternotomy on hemostasis. The present study aimed to investigate whether cell salvage processing has the same effects on postoperative blood loss and transfusion in minimally invasive cardiac surgery. Between July 2015 and April 2018, 80 consecutive patients undergoing minimally invasive aortic valve replacement via right anterolateral minithoracotomy were enrolled in the present study. Perioperative outcomes and coagulation data of 40 patients who were retransfused with processed cardiopulmonary bypass volumes were compared with those of 40 patients receiving unprocessed residual blood (control group). Postoperative blood loss in patients receiving processed residual blood was significantly less than that in the control group at 6 h (115 ± 50 vs. 73 ± 33 ml, p < 0.001) and 12 h (167 ± 70 vs. 125 ± 67 ml, p = 0.009) after surgery, and the rate of fresh frozen plasma use after surgery was significantly reduced in patients receiving processed residual blood (18 vs. 0%, p = 0.012). In conclusion, processing of residual cardiopulmonary bypass volume reduced postoperative blood loss and postoperative use of fresh frozen plasma and could be useful for hemostasis in minimally invasive cardiac surgery.
Literatur
1.
Zurück zum Zitat Shaw RE, Johnson CK, Ferrari G, Brizzio ME, Sayles K, Rioux N, Zapolanski A, Grau JB (2014) Blood transfusion in cardiac surgery does increase the risk of 5-year mortality: results from a contemporary series of 1714 propensity-matched patients. Transfusion 54:1106–1113CrossRefPubMed Shaw RE, Johnson CK, Ferrari G, Brizzio ME, Sayles K, Rioux N, Zapolanski A, Grau JB (2014) Blood transfusion in cardiac surgery does increase the risk of 5-year mortality: results from a contemporary series of 1714 propensity-matched patients. Transfusion 54:1106–1113CrossRefPubMed
2.
Zurück zum Zitat Society of Thoracic Surgeons Blood Conservation Guideline Task Force, Ferraris VA, Brown JR, Despotis GJ, Hammon JW, Reece TB, Saha SP, Song HK, Clough ER, Society of Cardiovascular Anesthesiologists Special Task Force on Blood Transfusion, Shore-Lesserson LJ, Goodnough LT, Mazer CD, Shander A, Stafford-Smith M, Waters J, International Consortium for Evidence Based Perfusion, Baker RA, Dickinson TA, FitzGerald DJ, Likosky DS, Shann KG (2011) 2011 update to the Society of Thoracic Surgeons and the Society of cardiovascular anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg 91:944–982CrossRef Society of Thoracic Surgeons Blood Conservation Guideline Task Force, Ferraris VA, Brown JR, Despotis GJ, Hammon JW, Reece TB, Saha SP, Song HK, Clough ER, Society of Cardiovascular Anesthesiologists Special Task Force on Blood Transfusion, Shore-Lesserson LJ, Goodnough LT, Mazer CD, Shander A, Stafford-Smith M, Waters J, International Consortium for Evidence Based Perfusion, Baker RA, Dickinson TA, FitzGerald DJ, Likosky DS, Shann KG (2011) 2011 update to the Society of Thoracic Surgeons and the Society of cardiovascular anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg 91:944–982CrossRef
3.
Zurück zum Zitat Konig G, Waters JH (2012) Washing and filtering of cell-salvaged blood—does it make autotransfusion safer? Transfus Altern Transfus Med 12:78–87CrossRefPubMedPubMedCentral Konig G, Waters JH (2012) Washing and filtering of cell-salvaged blood—does it make autotransfusion safer? Transfus Altern Transfus Med 12:78–87CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Daane CR, Golab HD, Meeder JH, Wijers MJ, Bogers AJ (2003) Processing and transfusion of residual cardiopulmonary bypass volume: effects on hemostasis, complement activation, postoperative blood loss and transfusion volume. Perfusion 18:115–121CrossRefPubMed Daane CR, Golab HD, Meeder JH, Wijers MJ, Bogers AJ (2003) Processing and transfusion of residual cardiopulmonary bypass volume: effects on hemostasis, complement activation, postoperative blood loss and transfusion volume. Perfusion 18:115–121CrossRefPubMed
5.
Zurück zum Zitat Wang G, Beinbrige D, Martin J, Cheng D (2009) The efficacy of intraoperative cell saver during cardiac surgery: a meta-analysis of randomized trials. Anesth Analg 109:320–330CrossRefPubMed Wang G, Beinbrige D, Martin J, Cheng D (2009) The efficacy of intraoperative cell saver during cardiac surgery: a meta-analysis of randomized trials. Anesth Analg 109:320–330CrossRefPubMed
6.
Zurück zum Zitat Hiraoka A, Nakajima K, Kuinose M, Totsugawa T, Yoshitaka H (2014) Initial large-dose administration of modified St. Thomas' solution. Asian Cardiovasc Thorac Ann 22:267–271CrossRefPubMed Hiraoka A, Nakajima K, Kuinose M, Totsugawa T, Yoshitaka H (2014) Initial large-dose administration of modified St. Thomas' solution. Asian Cardiovasc Thorac Ann 22:267–271CrossRefPubMed
7.
Zurück zum Zitat Sakaguchi T, Totsugawa T, Kuinose M, Tamura K, Hiraoka A, Chikazawa G, Yoshitaka H (2018) Minimally invasive mitral valve repair through right minithoracotomy—11-year single institute experience. Circ J 82:1705–1711CrossRefPubMed Sakaguchi T, Totsugawa T, Kuinose M, Tamura K, Hiraoka A, Chikazawa G, Yoshitaka H (2018) Minimally invasive mitral valve repair through right minithoracotomy—11-year single institute experience. Circ J 82:1705–1711CrossRefPubMed
8.
Zurück zum Zitat De Somer F, Van Belleghem Y, Caes F, François K, Van Overbeke H, Arnout J, Taeymans Y, Van Nooten G (2002) Tissue factor as the main activator of the coagulation system during cardiopulmonary bypass. J Thorac Cardiovasc Surg 123:951–958CrossRefPubMed De Somer F, Van Belleghem Y, Caes F, François K, Van Overbeke H, Arnout J, Taeymans Y, Van Nooten G (2002) Tissue factor as the main activator of the coagulation system during cardiopulmonary bypass. J Thorac Cardiovasc Surg 123:951–958CrossRefPubMed
9.
Zurück zum Zitat Sibbe J, Kluft C, Brommer EJ, Gomes M, de Joug DS, Nauta J (1984) Enhanced fibrinolytic activity during cardiopulmonary bypass in open-heart surgery in man is caused by extrinsic (tissue-type) plasminogen activator. Euro J Clin Investig 14:375–382CrossRef Sibbe J, Kluft C, Brommer EJ, Gomes M, de Joug DS, Nauta J (1984) Enhanced fibrinolytic activity during cardiopulmonary bypass in open-heart surgery in man is caused by extrinsic (tissue-type) plasminogen activator. Euro J Clin Investig 14:375–382CrossRef
10.
Zurück zum Zitat de Haan J, Schönberger J, Haan J, van Oeveren W, Eijgelaar A (1993) Tissue-type plasminogen activator and fibrin monomers synergistically cause platelet dysfunction during retransfusion of shed blood after cardiopulmonary bypass. J Thorac Cardiovasc Surg 106:1017–1023PubMed de Haan J, Schönberger J, Haan J, van Oeveren W, Eijgelaar A (1993) Tissue-type plasminogen activator and fibrin monomers synergistically cause platelet dysfunction during retransfusion of shed blood after cardiopulmonary bypass. J Thorac Cardiovasc Surg 106:1017–1023PubMed
11.
Zurück zum Zitat Schotola H, Wetz AJ, Propov AF, Bergmann I, Danner C, Schondube FA, Bauer M, Brauer A (2016) The effect of residual pump blood on patient plasma free hemoglobin levels post cardiac surgery. Anaesth Intensive Care 44:587–592CrossRefPubMed Schotola H, Wetz AJ, Propov AF, Bergmann I, Danner C, Schondube FA, Bauer M, Brauer A (2016) The effect of residual pump blood on patient plasma free hemoglobin levels post cardiac surgery. Anaesth Intensive Care 44:587–592CrossRefPubMed
12.
Zurück zum Zitat Da Q, Teruya M, Guchhait P, Teruya J, Olson JS, Cruz MA (2015) Free hemoglobin increases von Willebrand factor-mediated platelet adhesion in vitro: implications for circulatory devices. Blood 126:2338–2341CrossRefPubMedPubMedCentral Da Q, Teruya M, Guchhait P, Teruya J, Olson JS, Cruz MA (2015) Free hemoglobin increases von Willebrand factor-mediated platelet adhesion in vitro: implications for circulatory devices. Blood 126:2338–2341CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Kato GJ, McGowan V, Machado RF, Little JA, Taylor J VI, Morris CR, Nichols JS, Wang X, Poljakovic M, Morris SM Jr, Gladwin MT (2006) Lactate dehydrogenase as a biomarker of hemolysis-associated nitric oxide resistance, priapism, leg ulceration, pulmonary hypertension, and death in patients with sickle cell disease. Blood 107:2279–2285CrossRefPubMedPubMedCentral Kato GJ, McGowan V, Machado RF, Little JA, Taylor J VI, Morris CR, Nichols JS, Wang X, Poljakovic M, Morris SM Jr, Gladwin MT (2006) Lactate dehydrogenase as a biomarker of hemolysis-associated nitric oxide resistance, priapism, leg ulceration, pulmonary hypertension, and death in patients with sickle cell disease. Blood 107:2279–2285CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Rubens FD, Boodhwani M, Mesana T, Wozny D, Wells G, Nathan HJ (2007) Cardiotomy Investigators. The cardiotomy trial: a randomized, double-blind study to assess the effect of processing of shed blood during cardiopulmonary bypass on transfusion and neurocognitive function. Circulation 116:I89–I97CrossRefPubMed Rubens FD, Boodhwani M, Mesana T, Wozny D, Wells G, Nathan HJ (2007) Cardiotomy Investigators. The cardiotomy trial: a randomized, double-blind study to assess the effect of processing of shed blood during cardiopulmonary bypass on transfusion and neurocognitive function. Circulation 116:I89–I97CrossRefPubMed
15.
Zurück zum Zitat Scrascia G, Rotunno C, Nanna D, Rociola R, Guida P, Rubino G, Schinosa L, Paparella D (2012) Pump blood processing, salvage and re-transfusion improves hemoglobin levels after coronary artery bypass grafting, but affects coagulative and fibrinolytic systems. Perfusion 27:270–277CrossRefPubMed Scrascia G, Rotunno C, Nanna D, Rociola R, Guida P, Rubino G, Schinosa L, Paparella D (2012) Pump blood processing, salvage and re-transfusion improves hemoglobin levels after coronary artery bypass grafting, but affects coagulative and fibrinolytic systems. Perfusion 27:270–277CrossRefPubMed
16.
Zurück zum Zitat Campbell J, Holland C, Richens D, Skinner H (2011) Impact of cell salvage during cardiac surgery on the thrombelastomeric coagulation profile: a pilot study. Perfusion 27:221–224CrossRefPubMed Campbell J, Holland C, Richens D, Skinner H (2011) Impact of cell salvage during cardiac surgery on the thrombelastomeric coagulation profile: a pilot study. Perfusion 27:221–224CrossRefPubMed
17.
Zurück zum Zitat Glauber M, Miceli A, Gilmanov D, Ferrarini M, Bevilacqua S, Farneti PA, Solinas M (2013) Right anterior minithoracotomy versus conventional aortic valve replacement: a propensity score matched study. J Thorac Cardiovasc Surg 145:1222–1226CrossRefPubMed Glauber M, Miceli A, Gilmanov D, Ferrarini M, Bevilacqua S, Farneti PA, Solinas M (2013) Right anterior minithoracotomy versus conventional aortic valve replacement: a propensity score matched study. J Thorac Cardiovasc Surg 145:1222–1226CrossRefPubMed
18.
Zurück zum Zitat Totsugawa T, Hiraoka A, Tamura K, Yoshitaka H, Sakaguchi T (2019) Minimally invasive aortic valve replacement through a right anterolateral mini-thoracotomy for the treatment of octogenarians with aortic valve stenosis. Heart Vessels 34:462–469CrossRefPubMed Totsugawa T, Hiraoka A, Tamura K, Yoshitaka H, Sakaguchi T (2019) Minimally invasive aortic valve replacement through a right anterolateral mini-thoracotomy for the treatment of octogenarians with aortic valve stenosis. Heart Vessels 34:462–469CrossRefPubMed
Metadaten
Titel
Cell salvage processing of residual cardiopulmonary bypass volume in minimally invasive cardiac surgery
verfasst von
Ryosuke Muraki
Toshinori Totsugawa
Kazuyuki Nagata
Kosuke Nakajima
Tomoya Oshita
Masahisa Arimichi
Hidenori Yoshitaka
Taichi Sakaguchi
Publikationsdatum
27.02.2019
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 8/2019
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-019-01365-6

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