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O.K.

Who want's to do research of

Re-Transfusion devices

And figure out price supplier and wich ones would be more appropriate

to our practice environments ?

Their's a few hints/names of various devices I came across in my

search :

D E V I C E S

J Trauma. 1975 Aug;15(8):663-9. Related Articles, Links

Blood availability for the trauma patient-autotransfusion.

Mattox KL, LE, Beall AC, Jordan GL.

Recovery of intrathoracic and intraperitoneal blood and reinfusion by

autotransfusion has been demonstrated to be safe and practical in

selected trauma patients. Autotransfusion is ideally applicable to

the trauma patient in whom replacement of six or fewer units of blood

is required. In addition, autotransfusion provides readily available

blood for patients with unusual blood types and for those in whom

multiple transfusions may rapidly deplete available stores. The

properties of an ideal autotransfusion device include rapid assembly,

relatively low cost, ease of operation, in-line filtration, minimized

air blood interface, simplified anticoagulation, and safety from air

embolism and coagulopathies.

Ann Vasc Surg. 1986 May;1(1):131-3. Related Articles, Links

Intraoperative autotransfusion with a new disposable system.

Imhoff M, Schmidt R, Horsch S.

Institute of Anesthesiology, University of Koln, West Germany.

In the past 2 years we have used a simple, disposable set for

intraoperative autotransfusion. The system consists of a rigid

plastic case with a flexible bag inside constituting a 600 ml

reservoir which can be connected to any suitable vacuum source. We

used it so far in 56 patients undergoing various vascular operations

who were autotransfused a total of about 160 units of blood without

any complications with regard to blood coagulation or hemolysis.

Br J Surg. 1993 Jan;80(1):32-5. Related Articles, Links

Comment in:

• Br J Surg. 1993 Aug;80(8):1082.

Autotransfusion in aortic surgery: the Haemocell System 350 cell

saver.

Kalra M, Beech MJ, al-Khaffaf H, worth D.

Department of Surgery, University Hospital of South Manchester, UK.

Autotransfusion was performed during elective abdominal aortic

reconstruction in ten patients using the recently developed Haemocell

System 350. A mean of 60 per cent of total blood loss was salvaged,

and during operation each patient was autotransfused 1 unit. Good

preservation of cellular components, including platelets, was seen

after processing with the device, which uses a vortex mixing filter

for cell separation. There was no evidence of coagulopathy; mean free

plasma haemoglobin levels were slightly raised (17 mg/dl) and plasma

heparin concentration was negligible (0.10 units/ml) 4 h after

surgery. A transient drop in plasma fibrinogen levels and the

appearance of fibrin degradation products in low concentrations (mean

1.5 mg/l) were seen. Oxyhaemoglobin dissociation curves showed the

salvaged red blood cells to have a normal affinity for oxygen. Renal

and hepatic function remained unaltered and there were no

complications attributable to autotransfusion. The device was easy to

handle and a trained operator was not required.

Obstet Gynecol. 1988 Dec;72(6):947-50. Related Articles, Links

A simplified device for intraoperative autotransfusion.

Grimes DA.

Department of Obstetrics and Gynecology, Women's Hospital, University

of Southern California School of Medicine, Los Angeles.

Intraoperative autotransfusion, a widely accepted adjunct in many

surgical disciplines, has been underused in obstetrics and

gynecology. This report describes a new device for autotransfusion

that is simpler to operate than traditional systems requiring a

technician. The device was used successfully in two obstetric

patients with life-threatening intraoperative hemorrhage, one with

abdominal pregnancy and the other with postpartum hemorrhage. The

patients received autotransfusions of 1700 and 2200 mL, respectively,

without incident. Advantages of autotransfusion over banked blood

include avoidance of alloimmunization, reduction of transfusion

reactions and blood-borne infections, less expense, and acceptance by

most religious groups. Disadvantages include potential hemolysis and

limited usefulness in the presence of bacterial contamination or

malignancy. On balance, the benefits of autotransfusion outweigh the

risks.

Ugeskr Laeger. 1993 Mar 1;155(9):605-8. Related Articles, Links

[solcotrans, a new autotransfusion system]

[Article in Danish]

Dich Nielsen JO, Skoven A, Henneberg EW, Fasting H.

Anaestesi- og karkirurgisk afdeling, Skive Sygehus.

Thirty-one patients scheduled to undergo aortic reconstruction were

studied. 16 had aortic aneurysms and 15 required aortobifemoral

grafts. The solcotrans unit comprises a rigid plastic container with

an inner lining bag, into which blood is aspirated. When the bag is

full (500 ml), the unit is inverted and blood is re-infused through a

40 micron filter. Sixty-three percent of the blood transfused

per-operatively and 41% peri-operatively was given with the

solcotrans unit. Only minor changes in the coagulation parameters

were seen. Blood cultures from ten solcotrans units were all

negative. Two patients contracted pneumonia, and one cystitis. We

conclude that the solcotrans system is safe to use when two-to four

units of blood are transfused. Further studies are required to define

its role when multitransfusions of blood are needed.

Anaesthesist. 1983 Nov;32(11):538-44. Related Articles, Links

[Autotransfusion with the Sorensen apparatus]

[Article in German]

Homann B.

Since 1980 in Wurzburg the Sorensen autotransfusion unit has been

clinically used in 47 patients (35 vascular, 11 trauma patients, one

with arterial bleeding after BII, one with aneurysm of the a.

pericallosa) and tested to study its practicability, its advantages

and disadvantages. Within the laboratory data there was a small

decrease of hemoglobin, hematocrit and blood platelets, as well as of

the " Quick " and AT-3. PTT and thrombin-time persisted unchanged, as

did the results of electrolytes, parameters of renal and liver

function, and the status of blood gas analysis. Free hemoglobin i.s.

or i.u. was found in three patients with extremely high volume

autotransfusions. The autotransfusion unit is convenient, easy to use

and reliable. However, it is only suitable for the reinfusion of

blood when hemorrhage is moderate and not severe. Hemothorax blood

can be used only when adequate anti-fibrinolytic therapy is

guaranteed. Nevertheless, the use of the Sorensen autotransfusion

unit within the named diagnoses can achieve a precious contribution

for saving homologous blood.

J Trauma. 1987 May;27(5):537-42. Related Articles, Links

Use of the Heimlich valve in a compact autotransfusion device.

Schweitzer EJ, Hauer JM, Swan KG, Bresch JR, Harmon JW, Graeber GM.

A compact device which evacuates blood from a hemothorax and

facilitates rapid autotransfusion was evaluated in dogs. Experimental

hemothorax was established surgically by incising the internal

mammary artery through a thoracotomy with the animals under general

anesthesia. Postoperatively the blood was drained by one of two

methods. In the Heimlich valve group (n = 5), blood was drained by a

chest tube through a one-way flutter valve into a collapsible plastic

bag. In the Sorenson group (n = 5), blood was drained by a chest tube

into the Sorenson Autotransfusion System. Blood from these two groups

was then autotransfused. In the control group (n = 5), the drained

blood was not autotransfused. Results showed no statistical

difference between the two autotransfusion groups in the volume of

blood collected, circulating fibrinogen levels, platelet counts,

stroma-free hemoglobin levels, prothrombin time, or 51Cr-labeled RBC

survival. There was a significant drop in the circulating platelet

count, which returned to normal by 24 hours, in both groups of dogs

which were autotransfused. We conclude that autotransfusion of blood

collected by a compact device which utilizes a Heimlich valve and

requires no suction is similar to using the Sorenson Autotransfusion

System. It may be safe to use the Heimlich valve to collect blood for

autotransfusion in clinical situations, where its qualities of

simplicity, portability and a minimum requirement for storage space

are desirable.

Ther Apher. 1999 Feb;3(1):63-8. Related Articles, Links

Preliminary evaluation study of a prototype hollow fiber membrane for

the continuous membrane autotransfusion system.

Fukunaga K, Shimoyama T, Sueoka A, Nose Y.

Department of Surgery, Baylor College of Medicine, Houston, Texas

77030, USA. fukunaga@...

A totally new autotransfusion system has been developed utilizing a

hollow fiber membrane, based upon plasmapheresis technology. Prior to

fabricating the system, it was essential to evaluate the basic

performance characteristics of the filter, which was designed

particularly for the new system. The objective of this study was to

prove or disprove that such a system would be available using this

filter. An in vitro study was conducted on the filter using bovine

blood. The result of the study showed that the filter could process

2-20% of hematocrit blood at a flow rate greater than 250 ml/min of

inlet blood continuously. Moreover, it could concentrate 5-20%

hematocrit blood to hematocrit percentages greater than 40% by a

single passage through the filter. These results seemed to prove that

a rapid, continuous, and compact autotransfusion system could be

developed using this filter.

Br J Surg. 1995 Jun;82(6):765-9. Related Articles, Links

Clinical and experimental studies of intraoperative autotransfusion

using a new filtration device.

Varga ZA, JF, Locke-Edmunds JC, Baird RN, Farndon JR.

Department of Surgery, Bristol Royal Infirmary, UK.

The Haemocell S-350 device has recently been introduced for

intraoperative autotransfusion. The system uses a novel membrane

filter to process shed blood. In the first part of this study a

0.2-micron pore size filter was used in a randomized trial comparing

the use of autotransfusion (n = 8) with bank blood controls (n = 9)

during aortic reconstruction. This part of the trial was abandoned

because of unexpected non-surgical bleeding. Bank blood requirements

fell from a median of 3.0 (range 0.0-9.0) units to 1.5 (range

0.0-7.0) units when autotransfusion was used, but these patients had

a greater perioperative blood loss (1791 (range 932-3104) versus 1140

(range 440-3840) ml). There was evidence of postoperative heparin

excess with an activated partial thromboplastin time ratio of 1.3

(range 0.9-3.0) versus 1.0 (range 1.0-1.2) in controls and an

activated clotting time of 206 (range 143-280) versus 137 (range

107-142) s. This was confirmed by raised plasma heparin levels and a

prolonged thrombin time normalized by protamine. To improve

performance a 0.6-micron pore size filter was studied in ten

patients. Filtration efficiency doubled from 19 to 38 per cent.

Electron micrographs demonstrated better filter clearance, but 44 per

cent of the original concentration of heparin remained in the

reinfusate. The S-350 device may be an attractive alternative to

centrifugation for intraoperative autotransfusion but, until

efficiency is improved, it should only be used for cardiovascular

surgery when excess heparin can be reversed with protamine.

Artif Organs. 2000 Apr;24(4):289-95. Related Articles, Links

Development of the membrane autotransfusion system prototype-II:

MATS-II.

Fukunaga K, Shimoyama T, Sawada K, Sueoka A, Nose Y.

Department of Internal Medicine IV, Hyogo College of Medicine,

Nishinomiya, Hyogo, Japan.

This article is the second of a two-part series describing a membrane

autotransfusion system, MATS, utilizing plasmapheresis technology.

Based on experiences obtained from the first prototype (MATS-I),

optimum blood filtration parameters with refined blood and flux pump

synchronization were put into an original CPU-board and loaded on a

miniaturized, self-operative, and preclinical prototype (MATS-II).

This study was conducted to evaluate the MATS-II using diluted blood

of various hematocrit concentrations. The results proved that this

device could concentrate 4,000-10,000 ml of various hematocrit

concentrations into higher than 40% while automatically controlling

the flow speed from 250 to 400 ml/min. Also, no significant damage

was generated to the red blood cells (RBC). Moreover, the MATS-II

salvaged over 90% of platelets together with the RBC. These results

suggest that the MATS-II achieves all clinical requirements of an

autotransfusion device; it is a continuous hemoconcentration device

with minimum damage to cellular components of the blood.

Int J Artif Organs. 1998 Dec;21(12):820-4. Related Articles, Links

Blood separation with two different autotransfusion devices: effects

on blood cell quality and coagulation variables.

Rosolski T, Matthey T, Frick U, Hachenberg T.

Department of Anesthesiology and Intensive Care Medicine,

Ernst-Moritz-Arndt - University, Greifswald - Germany.

The quality of blood products obtained from two different

autotransfusion devices (CATS- Fresenius and Sequestra 1000 -

Medtronic) was tested in 27 patients undergoing elective orthopaedic

surgery. Blood products provided from our institutional blood bank (n

= 16) served as controls. Hemodiluted blood was separated into

platelet poor plasma (PPP), platelet rich plasma (PRP), and packed

red cells (PRC) and analysed for blood cell count, fibrinogen

concentration, thromboplastin time, partial thromboplastin time,

platelet aggregation and platelet recovery rate. Coagulation

variables showed no differences between the CATS-group (n = 14) and

the Sequestra 1000-group (n = 13). The volume of PRP was lower in the

Sequestra 1000-group (45+/-3 ml vs. 89+/-1 ml, p<0.05), but

hematocrit was higher (14.4+/-7.8% vs. 8.5+/-2.8%, p<0.05). PPP

produced with CATS contained a higher concentration of white blood

cells (0.6+/-0.2 Gpt/l vs. 0.1+/-0.01 Gpt/l, p<0.05) and thrombocytes

(163+/-74 Gpt/l vs. 11+/-12 Gpt/l, p<0.05). Hematocrit of PRC was

significantly higher in the CATS-group (73.8+/-2.0% vs. 69.0+/-6.5%,

p<0.05). Blood products were of high quality in both groups and

comparable to or superior than blood products provided from our

institutional blood bank.

Ann Biomed Eng. 2000 Apr;28(4):470-82. Related Articles, Links

A simulation study for the design of a control system for the blood

concentration process in autotransfusion.

Ruggeri A, Comai G, Belloni M, Zanella A.

Department of Electronics and Computer Engineering, University of

Padova, Italy. ruggeri@...

Autotransfusion is the process in which a patient serves as his or

her own blood donor; its most important application is the

intraoperative blood salvage, in which the blood collected during a

surgical operation is filtered, concentrated, washed, and then

reinfused. In an automatic autotransfusion device, such as the DIDECO

Compact Advanced, red blood cells (RBCs) are separated from the other

unwanted components and concentrated by using a rotating bowl and the

effect of centrifugal force. An important characteristic of

concentrated RBCs is their hematocrit (Hct), i.e., percent RBC volume

divided by total blood volume. The aim of this study is to assess the

feasibility of a controller, based on the artificial neural network

approach, which is able to provide a closed loop control of the

hematocrit of the blood in the bowl at the end of the concentration

phase. A simulation approach was adopted both for training the

network and for assessing its performances. The results obtained are

quite satisfactory, since the target Hct was typically reached within

a 3% error, and always within 6% in highly challenging situations.

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Having no experience with autotransfusion, I did some searching on the net

and found a really good PDF file from Atrium, the makers of a

autotransfusion set. " A Personal Guide to Managing Chest Drain

Autotransfusions " .

There is a local (as opposed to systemic, like heparin) anticoagulant you

can add to the collection system to prevent coagulation before

retransfusion.

Download it from:

http://www.atriummed.com/PDF/Red%20Handbook.pdf

This site has some interesting links on chest drain education at:

http://www.atriummed.com/Products/Chest_Drains/education.asp

I have no financial interest in this company.

Jim

Re: chest darts (Devices)

O.K.

Who want's to do research of

Re-Transfusion devices

And figure out price supplier and wich ones would be more appropriate to our

practice environments ?

Their's a few hints/names of various devices I came across in my search :

D E V I C E S

J Trauma. 1975 Aug;15(8):663-9. Related Articles, Links

Blood availability for the trauma patient-autotransfusion.

Mattox KL, LE, Beall AC, Jordan GL.

Recovery of intrathoracic and intraperitoneal blood and reinfusion by

autotransfusion has been demonstrated to be safe and practical in selected

trauma patients. Autotransfusion is ideally applicable to the trauma patient

in whom replacement of six or fewer units of blood is required. In addition,

autotransfusion provides readily available blood for patients with unusual

blood types and for those in whom multiple transfusions may rapidly deplete

available stores. The properties of an ideal autotransfusion device include

rapid assembly, relatively low cost, ease of operation, in-line filtration,

minimized air blood interface, simplified anticoagulation, and safety from

air embolism and coagulopathies.

Ann Vasc Surg. 1986 May;1(1):131-3. Related Articles, Links

Intraoperative autotransfusion with a new disposable system.

Imhoff M, Schmidt R, Horsch S.

Institute of Anesthesiology, University of Koln, West Germany.

In the past 2 years we have used a simple, disposable set for intraoperative

autotransfusion. The system consists of a rigid plastic case with a flexible

bag inside constituting a 600 ml reservoir which can be connected to any

suitable vacuum source. We used it so far in 56 patients undergoing various

vascular operations who were autotransfused a total of about 160 units of

blood without any complications with regard to blood coagulation or

hemolysis.

Br J Surg. 1993 Jan;80(1):32-5. Related Articles, Links

Comment in:

.. Br J Surg. 1993 Aug;80(8):1082.

Autotransfusion in aortic surgery: the Haemocell System 350 cell saver.

Kalra M, Beech MJ, al-Khaffaf H, worth D.

Department of Surgery, University Hospital of South Manchester, UK.

Autotransfusion was performed during elective abdominal aortic

reconstruction in ten patients using the recently developed Haemocell System

350. A mean of 60 per cent of total blood loss was salvaged, and during

operation each patient was autotransfused 1 unit. Good preservation of

cellular components, including platelets, was seen after processing with the

device, which uses a vortex mixing filter for cell separation. There was no

evidence of coagulopathy; mean free plasma haemoglobin levels were slightly

raised (17 mg/dl) and plasma heparin concentration was negligible (0.10

units/ml) 4 h after surgery. A transient drop in plasma fibrinogen levels

and the appearance of fibrin degradation products in low concentrations

(mean 1.5 mg/l) were seen. Oxyhaemoglobin dissociation curves showed the

salvaged red blood cells to have a normal affinity for oxygen. Renal and

hepatic function remained unaltered and there were no complications

attributable to autotransfusion. The device was easy to handle and a trained

operator was not required.

Obstet Gynecol. 1988 Dec;72(6):947-50. Related Articles, Links

A simplified device for intraoperative autotransfusion.

Grimes DA.

Department of Obstetrics and Gynecology, Women's Hospital, University of

Southern California School of Medicine, Los Angeles.

Intraoperative autotransfusion, a widely accepted adjunct in many surgical

disciplines, has been underused in obstetrics and gynecology. This report

describes a new device for autotransfusion that is simpler to operate than

traditional systems requiring a technician. The device was used successfully

in two obstetric patients with life-threatening intraoperative hemorrhage,

one with abdominal pregnancy and the other with postpartum hemorrhage. The

patients received autotransfusions of 1700 and 2200 mL, respectively,

without incident. Advantages of autotransfusion over banked blood include

avoidance of alloimmunization, reduction of transfusion reactions and

blood-borne infections, less expense, and acceptance by most religious

groups. Disadvantages include potential hemolysis and limited usefulness in

the presence of bacterial contamination or malignancy. On balance, the

benefits of autotransfusion outweigh the risks.

Ugeskr Laeger. 1993 Mar 1;155(9):605-8. Related Articles, Links

[solcotrans, a new autotransfusion system]

[Article in Danish]

Dich Nielsen JO, Skoven A, Henneberg EW, Fasting H.

Anaestesi- og karkirurgisk afdeling, Skive Sygehus.

Thirty-one patients scheduled to undergo aortic reconstruction were studied.

16 had aortic aneurysms and 15 required aortobifemoral grafts. The

solcotrans unit comprises a rigid plastic container with an inner lining

bag, into which blood is aspirated. When the bag is full (500 ml), the unit

is inverted and blood is re-infused through a 40 micron filter. Sixty-three

percent of the blood transfused per-operatively and 41% peri-operatively was

given with the solcotrans unit. Only minor changes in the coagulation

parameters were seen. Blood cultures from ten solcotrans units were all

negative. Two patients contracted pneumonia, and one cystitis. We conclude

that the solcotrans system is safe to use when two-to four units of blood

are transfused. Further studies are required to define its role when

multitransfusions of blood are needed.

Anaesthesist. 1983 Nov;32(11):538-44. Related Articles, Links

[Autotransfusion with the Sorensen apparatus]

[Article in German]

Homann B.

Since 1980 in Wurzburg the Sorensen autotransfusion unit has been clinically

used in 47 patients (35 vascular, 11 trauma patients, one with arterial

bleeding after BII, one with aneurysm of the a.

pericallosa) and tested to study its practicability, its advantages and

disadvantages. Within the laboratory data there was a small decrease of

hemoglobin, hematocrit and blood platelets, as well as of the " Quick " and

AT-3. PTT and thrombin-time persisted unchanged, as did the results of

electrolytes, parameters of renal and liver function, and the status of

blood gas analysis. Free hemoglobin i.s. or i.u. was found in three patients

with extremely high volume autotransfusions. The autotransfusion unit is

convenient, easy to use and reliable. However, it is only suitable for the

reinfusion of blood when hemorrhage is moderate and not severe. Hemothorax

blood can be used only when adequate anti-fibrinolytic therapy is

guaranteed. Nevertheless, the use of the Sorensen autotransfusion unit

within the named diagnoses can achieve a precious contribution for saving

homologous blood.

J Trauma. 1987 May;27(5):537-42. Related Articles, Links

Use of the Heimlich valve in a compact autotransfusion device.

Schweitzer EJ, Hauer JM, Swan KG, Bresch JR, Harmon JW, Graeber GM.

A compact device which evacuates blood from a hemothorax and facilitates

rapid autotransfusion was evaluated in dogs. Experimental hemothorax was

established surgically by incising the internal mammary artery through a

thoracotomy with the animals under general anesthesia. Postoperatively the

blood was drained by one of two methods. In the Heimlich valve group (n =

5), blood was drained by a chest tube through a one-way flutter valve into a

collapsible plastic bag. In the Sorenson group (n = 5), blood was drained by

a chest tube into the Sorenson Autotransfusion System. Blood from these two

groups was then autotransfused. In the control group (n = 5), the drained

blood was not autotransfused. Results showed no statistical difference

between the two autotransfusion groups in the volume of blood collected,

circulating fibrinogen levels, platelet counts, stroma-free hemoglobin

levels, prothrombin time, or 51Cr-labeled RBC survival. There was a

significant drop in the circulating platelet count, which returned to normal

by 24 hours, in both groups of dogs which were autotransfused. We conclude

that autotransfusion of blood collected by a compact device which utilizes a

Heimlich valve and requires no suction is similar to using the Sorenson

Autotransfusion System. It may be safe to use the Heimlich valve to collect

blood for autotransfusion in clinical situations, where its qualities of

simplicity, portability and a minimum requirement for storage space are

desirable.

Ther Apher. 1999 Feb;3(1):63-8. Related Articles, Links

Preliminary evaluation study of a prototype hollow fiber membrane for the

continuous membrane autotransfusion system.

Fukunaga K, Shimoyama T, Sueoka A, Nose Y.

Department of Surgery, Baylor College of Medicine, Houston, Texas 77030,

USA. fukunaga@...

A totally new autotransfusion system has been developed utilizing a hollow

fiber membrane, based upon plasmapheresis technology. Prior to fabricating

the system, it was essential to evaluate the basic performance

characteristics of the filter, which was designed particularly for the new

system. The objective of this study was to prove or disprove that such a

system would be available using this filter. An in vitro study was conducted

on the filter using bovine blood. The result of the study showed that the

filter could process 2-20% of hematocrit blood at a flow rate greater than

250 ml/min of inlet blood continuously. Moreover, it could concentrate 5-20%

hematocrit blood to hematocrit percentages greater than 40% by a single

passage through the filter. These results seemed to prove that a rapid,

continuous, and compact autotransfusion system could be developed using this

filter.

Br J Surg. 1995 Jun;82(6):765-9. Related Articles, Links

Clinical and experimental studies of intraoperative autotransfusion using a

new filtration device.

Varga ZA, JF, Locke-Edmunds JC, Baird RN, Farndon JR.

Department of Surgery, Bristol Royal Infirmary, UK.

The Haemocell S-350 device has recently been introduced for intraoperative

autotransfusion. The system uses a novel membrane filter to process shed

blood. In the first part of this study a 0.2-micron pore size filter was

used in a randomized trial comparing the use of autotransfusion (n = 8) with

bank blood controls (n = 9) during aortic reconstruction. This part of the

trial was abandoned because of unexpected non-surgical bleeding. Bank blood

requirements fell from a median of 3.0 (range 0.0-9.0) units to 1.5 (range

0.0-7.0) units when autotransfusion was used, but these patients had a

greater perioperative blood loss (1791 (range 932-3104) versus 1140 (range

440-3840) ml). There was evidence of postoperative heparin excess with an

activated partial thromboplastin time ratio of 1.3 (range 0.9-3.0) versus

1.0 (range 1.0-1.2) in controls and an activated clotting time of 206 (range

143-280) versus 137 (range

107-142) s. This was confirmed by raised plasma heparin levels and a

prolonged thrombin time normalized by protamine. To improve performance a

0.6-micron pore size filter was studied in ten patients. Filtration

efficiency doubled from 19 to 38 per cent. Electron micrographs demonstrated

better filter clearance, but 44 per cent of the original concentration of

heparin remained in the reinfusate. The S-350 device may be an attractive

alternative to centrifugation for intraoperative autotransfusion but, until

efficiency is improved, it should only be used for cardiovascular surgery

when excess heparin can be reversed with protamine.

Artif Organs. 2000 Apr;24(4):289-95. Related Articles, Links

Development of the membrane autotransfusion system prototype-II: MATS-II.

Fukunaga K, Shimoyama T, Sawada K, Sueoka A, Nose Y.

Department of Internal Medicine IV, Hyogo College of Medicine, Nishinomiya,

Hyogo, Japan.

This article is the second of a two-part series describing a membrane

autotransfusion system, MATS, utilizing plasmapheresis technology. Based on

experiences obtained from the first prototype (MATS-I), optimum blood

filtration parameters with refined blood and flux pump synchronization were

put into an original CPU-board and loaded on a miniaturized, self-operative,

and preclinical prototype (MATS-II). This study was conducted to evaluate

the MATS-II using diluted blood of various hematocrit concentrations. The

results proved that this device could concentrate 4,000-10,000 ml of various

hematocrit concentrations into higher than 40% while automatically

controlling the flow speed from 250 to 400 ml/min. Also, no significant

damage was generated to the red blood cells (RBC). Moreover, the MATS-II

salvaged over 90% of platelets together with the RBC. These results suggest

that the MATS-II achieves all clinical requirements of an autotransfusion

device; it is a continuous hemoconcentration device with minimum damage to

cellular components of the blood.

Int J Artif Organs. 1998 Dec;21(12):820-4. Related Articles, Links

Blood separation with two different autotransfusion devices: effects on

blood cell quality and coagulation variables.

Rosolski T, Matthey T, Frick U, Hachenberg T.

Department of Anesthesiology and Intensive Care Medicine, Ernst-Moritz-Arndt

- University, Greifswald - Germany.

The quality of blood products obtained from two different autotransfusion

devices (CATS- Fresenius and Sequestra 1000 -

Medtronic) was tested in 27 patients undergoing elective orthopaedic

surgery. Blood products provided from our institutional blood bank (n = 16)

served as controls. Hemodiluted blood was separated into platelet poor

plasma (PPP), platelet rich plasma (PRP), and packed red cells (PRC) and

analysed for blood cell count, fibrinogen concentration, thromboplastin

time, partial thromboplastin time, platelet aggregation and platelet

recovery rate. Coagulation variables showed no differences between the

CATS-group (n = 14) and the Sequestra 1000-group (n = 13). The volume of PRP

was lower in the Sequestra 1000-group (45+/-3 ml vs. 89+/-1 ml, p<0.05), but

hematocrit was higher (14.4+/-7.8% vs. 8.5+/-2.8%, p<0.05). PPP produced

with CATS contained a higher concentration of white blood cells (0.6+/-0.2

Gpt/l vs. 0.1+/-0.01 Gpt/l, p<0.05) and thrombocytes (163+/-74 Gpt/l vs.

11+/-12 Gpt/l, p<0.05). Hematocrit of PRC was significantly higher in the

CATS-group (73.8+/-2.0% vs. 69.0+/-6.5%, p<0.05). Blood products were of

high quality in both groups and comparable to or superior than blood

products provided from our institutional blood bank.

Ann Biomed Eng. 2000 Apr;28(4):470-82. Related Articles, Links

A simulation study for the design of a control system for the blood

concentration process in autotransfusion.

Ruggeri A, Comai G, Belloni M, Zanella A.

Department of Electronics and Computer Engineering, University of Padova,

Italy. ruggeri@...

Autotransfusion is the process in which a patient serves as his or her own

blood donor; its most important application is the intraoperative blood

salvage, in which the blood collected during a surgical operation is

filtered, concentrated, washed, and then reinfused. In an automatic

autotransfusion device, such as the DIDECO Compact Advanced, red blood cells

(RBCs) are separated from the other unwanted components and concentrated by

using a rotating bowl and the effect of centrifugal force. An important

characteristic of concentrated RBCs is their hematocrit (Hct), i.e., percent

RBC volume divided by total blood volume. The aim of this study is to assess

the feasibility of a controller, based on the artificial neural network

approach, which is able to provide a closed loop control of the hematocrit

of the blood in the bowl at the end of the concentration phase. A simulation

approach was adopted both for training the network and for assessing its

performances. The results obtained are quite satisfactory, since the target

Hct was typically reached within a 3% error, and always within 6% in highly

challenging situations.

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Please visit our website http://www.remotemedics.co.uk

Regards

The Remote Medics Team

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--- Dawdy <jdawdy@...> wrote:

> Having no experience with autotransfusion, I did some searching on

> the net and found a really good PDF file from Atrium, the makers of

> a autotransfusion set. " A Personal Guide to Managing Chest Drain

> Autotransfusions " .

>

> Jim

>

W O W !

Excellent site

Good training and product support

But I can't help noticing how bulky and breakable the equipment

appears...

So I've looked a bit further and found :

http://www.vitaid.com/usa/celltrans/

http://www.vitaid.com/usa/celltrans/CellTransBrochure.pdf

&

http://www.sigroupplc.com/haemocell-index1.html

Also

Another article in PreHosp AutoTransfusion :

Chest, Vol 93, 522-526,

Copyright © 1988 by American College of Chest Physicians

Prehospital autotransfusion in life-threatening hemothorax

P Barriot, B Riou and P Viars

Service de Sante de la Brigade des Sapeurs Pompiers de Paris, France.

Eighteen patients with life-threatening traumatic hemothorax received

prehospital autotransfusion using a simple new device. During

transfer to the hospital, they received 3.9 +/- 0.5 L of colloid

fluid and 4.1 +/- 0.6 L of autotransfused blood, without

anticoagulation.

Hemorrhagic blood was not coagulable, had a hematocrit of 20 +/- 4

percent, few platelets, and low fibrinogen levels.

Five patients died from irreversible hemorrhagic shock.

Thirteen patients were alive upon admission to the hospital,

underwent emergency surgery, and were discharged alive.

During autotransfusion,

hematocrit decreased from 24 +/- 3 to 19 +/- 3 percent,

and systolic arterial pressure increased

from 78 +/- 11 to 88 +/- 12 mm Hg.

Upon admission to the hospital,

platelet count was 90,800 +/- 21,400/cu mm,

prothrombin time 48 +/- 3 percent,

partial thromboplastin time 197 +/- 18 percent,

plasma free hemoglobin levels 21 +/- 7 mg/100 ml,

and serum potassium levels 3.6 +/- 0.5 mmol/L.

No serious complication could be related to autotransfusion

considered to be crucial to patients' survival. The preliminary

results of this study suggest that autotransfusion might be developed

in the prehospital setting since it appears simple and safe, and

represents the only hope of survival for patients with

life-threatening hemothorax.

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Hey -

My partner today, Cusson, says hello. He saw your name on the post

about capnography, as I printed it and posted it in the station. We use

both ETCO and SaO2 via a ProPaq in all of our helicopters. He will look

you up when he goes back to Montreal later this year.

Cheers

Jerry

RE: chest darts (Devices)

--- Dawdy <jdawdy@...> wrote:

> Having no experience with autotransfusion, I did some searching on the

> net and found a really good PDF file from Atrium, the makers of a

> autotransfusion set. " A Personal Guide to Managing Chest Drain

> Autotransfusions " .

>

> Jim

>

W O W !

Excellent site

Good training and product support

But I can't help noticing how bulky and breakable the equipment

appears...

So I've looked a bit further and found :

http://www.vitaid.com/usa/celltrans/

http://www.vitaid.com/usa/celltrans/CellTransBrochure.pdf

&

http://www.sigroupplc.com/haemocell-index1.html

Also

Another article in PreHosp AutoTransfusion :

Chest, Vol 93, 522-526,

Copyright C 1988 by American College of Chest Physicians

Prehospital autotransfusion in life-threatening hemothorax

P Barriot, B Riou and P Viars

Service de Sante de la Brigade des Sapeurs Pompiers de Paris, France.

Eighteen patients with life-threatening traumatic hemothorax received

prehospital autotransfusion using a simple new device. During transfer

to the hospital, they received 3.9 +/- 0.5 L of colloid fluid and 4.1

+/- 0.6 L of autotransfused blood, without anticoagulation.

Hemorrhagic blood was not coagulable, had a hematocrit of 20 +/- 4

percent, few platelets, and low fibrinogen levels.

Five patients died from irreversible hemorrhagic shock.

Thirteen patients were alive upon admission to the hospital, underwent

emergency surgery, and were discharged alive.

During autotransfusion,

hematocrit decreased from 24 +/- 3 to 19 +/- 3 percent,

and systolic arterial pressure increased

from 78 +/- 11 to 88 +/- 12 mm Hg.

Upon admission to the hospital,

platelet count was 90,800 +/- 21,400/cu mm,

prothrombin time 48 +/- 3 percent,

partial thromboplastin time 197 +/- 18 percent,

plasma free hemoglobin levels 21 +/- 7 mg/100 ml,

and serum potassium levels 3.6 +/- 0.5 mmol/L.

No serious complication could be related to autotransfusion considered

to be crucial to patients' survival. The preliminary results of this

study suggest that autotransfusion might be developed in the prehospital

setting since it appears simple and safe, and represents the only hope

of survival for patients with life-threatening hemothorax.

Member Information:

List owner: Ian Sharpe Owner@...

Editor: Ross Boardman Editor@...

ALL list admin messages (subscriptions & unsubscriptions) should be sent

to the list owner.

Post message: egroups

Please visit our website http://www.remotemedics.co.uk

Regards

The Remote Medics Team

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