Funded internally by the Hamilton Health Sciences Center.
Processed residual pump blood in cardiac surgery: the Processed Residual Blood in Cardiac surgery trial
Article first published online: 26 NOV 2012
© 2012 American Association of Blood Banks
Volume 53, Issue 7, pages 1487–1492, July 2013
How to Cite
Whitlock, R., Mathew, J., Eikelboom, J., Al-Saleh, A. M., Yuan, F. and Teoh, K. (2013), Processed residual pump blood in cardiac surgery: the Processed Residual Blood in Cardiac surgery trial. Transfusion, 53: 1487–1492. doi: 10.1111/j.1537-2995.2012.03958.x
ClinicalTrials.gov Identifier: NCT01173822.
- Issue published online: 11 JUL 2013
- Article first published online: 26 NOV 2012
- Manuscript Accepted: 26 SEP 2012
- Manuscript Revised: 21 SEP 2012
- Manuscript Received: 13 JUL 2012
- Hamilton Health Sciences Center
Processing residual cardiopulmonary bypass (CPB) volume via ultrafiltration may improve hemostasis and reduce transfusion through clearing activated complement, activated coagulation components, and proinflammatory cytokines. We sought to establish if processing residual CPB volume with ultrafiltration reduces homologous blood transfusion and bleeding.
Study Design and Methods
Adult patients undergoing isolated coronary artery bypass grafting (CABG) surgery were randomly assigned to receive processed (n = 99) or unprocessed (control; n = 98) residual CPB volume in this single-center randomized controlled trial. The intensive care unit team, patients, and assessors were blinded to treatment assignment and a transfusion protocol was followed. Surgeons were permitted to use retrograde autologous priming to minimize crystalloid pump prime.
The processed study bag was of a smaller volume (280 [0, 550] mL vs. 590 [215, 726] mL; p < 0.01) but a higher hematocrit (29% [0%, 34%] vs. 23% [20%, 25%]; p < 0.01) than control. The rate of transfusion with homologous blood was 39% in both groups (p = 0.92). There was no difference in the volume transfused (processed 323 ± 585 mL vs. control 276 ± 520 mL; p = 0.56). There was also no difference in the proportion of patients transfused with any blood product (processed 44% vs. control 45%; p = 0.95) or in the volume of chest tube output (processed 600 [500, 940] mL vs. control 670 [490, 932] mL; p = 0.62).
Ultrafiltration of residual CPB volume in adults undergoing isolated CABG surgery does not reduce the need for transfusion or bleeding.