A comparison of haemostatic biomarkers during low-risk patients undergoing cardiopulmonary bypass using either conventional centrifugal cell salvage or the HemoSep device

Abstract

Although centrifuged cell salvage is known to adequately haemoconcentrate and remove unwanted substrates and bacteriological contamination, the process can exacerbate coagulopathy. The HemoSep device demonstrated some increase in haemostatic markers when used in low-risk cardiac surgery patients.

Autotransfusion using a novel ultrafiltration device (Hemosep, Advancis Surgical) for the management of acute intraoperative haemorrhage in a dog

“…The Hemosep bag consists of a polyvinylchloride bag with a polycarbonate membrane in the centre containing a sheet of superabsorber material. The superabsorber material presents a 1 µm filter; this pore size allows efficient fluid transport into the superabsorber 12. As the passage of plasma is not restricted the final result consists of concentration of the cellular components of the blood within the bag but removing the plasma fluid fraction, fragmented cells and molecules below the pore size.…”

“…Comparing the quality of the erythrocytes in fresh versus stored blood products, when RBCs are stored they suffer storage lesions that act as proinflammatory and immunomodulatory agents 6 10. Moreover, RBCs lifespan and function are decreased, aggregation is increased and morphological abnormalities lead to increased viscosity and osmotic fragility 11 12. During storage 2,3‐diphosphoglycerate is depleted, which results in left shift of the oxyhaemoglobin dissociation curve and impaired oxygen off‐loading to the tissues 13.…”

“…In veterinary medicine the use of centrifuge‐based devices has been reported in cases of thoracic and abdominal haemorrhage as either solo treatment or with the aim of reducing allogenic transfusion requirements 7 8. Hemosep device differs from conventional centrifuge‐based devices as it produces a blood concentrate which preserves the RBCs and platelets, albumin, WBCs and clotting factors, using an ultrafiltration technique 12 14. The Hemosep system consists of four major components: (1) Hemosep bag, (2) Hemosep shaker unit, (3) blood collection bag, and (4) intraoperative pump, suction and blood reservoir (figure 1).…”

“…The current costs of the shaker unit, concentrator bag kit and intraoperative kit (new reservoir and suction) are £4000, £93 and £130, respectively. Disposables for centrifuge and ultrafiltration devices in human medicine are comparable or cheaper than a single unit of allogenic blood 12. Moreover, the volume of waste products from Hemosep is lower, safer and easier to dispose compared with the large volumes of fluid associated with other centrifuge‐based devices 15…”

Traditional and emerging technologies for washing and volume reducing blood products

“…HemoSep (Brightwake, Nottinghamshire, UK) is a hemoconcentration system developed to soak up to 250 mL of excess plasma during blood salvage without the use of centrifugation 64–66. The primary component of the HemoSep system is a blood bag separated into two compartments by a filter membrane, which prevents cells in the blood compartment of the bag from entering the super-absorber pad contained in the other compartment of the bag.…”