Transcript The Hemobag - A New Technology for Blood Conservation

A New Technology for
Blood Conservation using
Hemoconcentration
A Universal Blood Reservoir for Salvaging
Autologous Whole Blood from any ECC.
The Hemobag ® is specifically designed for
Filling, Hemoconcentrating and Infusing
Blood Quickly all in the same device, and
will double the use of any commercially
available Hemoconcentrator. It even keeps
the ECC circuit primed at all times for
piece of mind and security.
Hemobag® Case Series
Salem Hospital, Salem OR
HB vs. NHB group comparison:
 No significant difference in distribution of surgeons,
procedures, patient age, BSA or gender between groups
 No significant difference in CPB and ischemic (clamp)
times between groups
 No significant difference in National Bayes Risk Scores
but the Hemobag® Pts. trended to Higher Risk Scores
 HB group cooled to a significantly (p = 0.45) lower
temperature (30.6 oC) than control group (32.9 oC)
 Same volume of pre-CPB autologous blood drawn (ANH)
 Same 100% use of cell-processor in both groups except
the use of the HemoBag® to process the end-CPB circuit
volume in the HB group
Hemobag® Case Series
Salem Hospital, Salem OR
Methodology
 The end-CPB circuit blood for a group of 41 patients was processed using
the Hemobag® (HB) device and technique
 HB procedures and patients were selected randomly from all comers in
community-based medical center
 A retrospective, matched patient group (non-HemoBag®, NHB) was
selected to compare to the Hemobag® patient group
 The control group patients were selected to match the HB group patients by
procedure, surgeon, CPB time, Clamp time, age and BSA
 The control group end-CPB circuit blood was processed by the Cell Saver®
 Compared pre-op, operative, ICU and post-op parameters, outcomes and
blood product usage and cost between HB and NHB groups
Hemobag® Case Series
Salem Hospital, Salem OR
HB vs. NHB group comparison:
 There was no difference in operative hematocrit
nadir, post-op HCT or chest tube drainage volume
 Though not statistically significant at group sizes
(n= 41), the differences were clinically relevant, and
had sizeable financial consequences:
 Hemobag® patients received 1/3 less total donor exposures
on the average compared to control group
 Average RBC transfusion rates per patient were lower
(>50%) in the HB group (p = 0.081) compared to the control
patients
 Hemobag® patients blood costs were about 50% of control
group blood costs per patient (p = 0.134)
More patients received no blood
products in HemoBag® group
% Patients
receiving no
donor blood
34 %
Treatment Group
 49% of the
HemoBag® patients
received no blood
products compared to
34% of the control
group patients
NHB
49 %
HB
0
10
20
30
40
50
Percent of patients receiving no
blood products
 All blood products for
the 41 HemoBag®
patients cost about
$27,631 versus
$50,564 for the 41
control group patients.
 A Difference of
$23,933 was realized
in the 41 Patients in
the Hemobag® group.
Treatment Group
Total cost of blood products was
reduced in the HemoBag® group
NHB
PRC $K
FFP $K
HB
PLAT $K
$0
$10
$20
$30
$40
$50
Cost of Blood Products $K
$60
FLAGSHIP CASE #1: Over 80y/o female, AVR case, post-op
bleeding: 300mL, left ICU post-op Day #1, no blood products given
• Reinfused 900 mL Conc.
Autologous Whole Blood from
CPB circuit with:
–
–
–
–
–
Hct = 57%
Platelets = 364 K
Fibrinogen = 740 mg
Albumin = 6.6 g/dL
Total protein = 11.7 g/dL
Change in Blood Parameters
Patient
Hemobag
740
800
700
600
500
400
300
200
100
0
364
221
155
57
23
Plt. Ct. k/cumm
• Time: 12 minutes
• Extracorporeal circuit kept viable
& ready to go back emergently
Fibrinogen mg/dl
HCT %
Change in Protein Levels
15
10
Results represent what is
possible with the
Hemobag®
5
0
Albumin gm/dl
Total Protein gm/dl
Patient
2.3
4
Hemobag
6.6
11.7
FLAGSHIP CASE #2: 60 yr old CABG x 3, post-op bleeding was
290 mL, left ICU on Post-op Day #1, no blood products given
• Reinfused 1150 mL Conc.
Autologous Whole Blood from
CPB circuit with:
–
–
–
–
–
–
Hct = 56%
Platelets = 430 K
Fibrinogen = 972 mg
Albumin = 5.7 g/dL
Total protein = 13.6 g/dL
300% increase in FVII
• 73% activity to 223%
Change in Blood Parameters
Patient
972
1000
800
600
430
400
292
241
200
26
0
Plt. Ct. k/cumm Fibrinogen mg/dl
HCT %
Change in Protein Levels
• Time: 10 minutes
• Extracorporeal circuit kept
viable & ready to go back
Illustrates capabilities of the
Hemobag® when used for Whole
Blood Salvaging in CV Surgery
Hemobag
15
10
5
0
Albumin gm/dl
Total Protein gm/dl
Patient
2.1
4.1
Hemobag
5.7
13.6
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