Cardiopulmonary Bypass Clinical Trial
Official title:
Comparison of Whole Blood Return and Normal Practice Red Blood Cell Salvage Return Following Cardiopulmonary Bypass
The avoidance of blood transfusions benefits the patient. Cardiopulmonary bypass (CPB) is routinely used in complex cardiac surgeries. This device requires circulating blood through an oxygenator and pump while the heart is stopped. Upon discontinuation of CPB, the volume of blood in the CPB circuit, approximately 1 to 1.5 liters, is currently processed for the red cell components of the blood. Yet, all the other blood components are available in this volume of blood, but are discarded. The Hemobag filters allow for whole blood reinfusion rather than just red cell reinfusion. Thus, the patient’s own platelets, for example, are returned to the patient. The product is just being used clinically and we, the investigators at University of Medicine and Dentistry, New Jersey, have been asked to perform a study on our normal practice (red blood cell return as described above) compared to the whole blood return available with the Hemobag™.
The HemobagTM is a bag containing a microfilter for separation of autologous whole blood
from intravenous solutions to provide a whole blood reinfusion from a cardiopulmonary bypass
machine.
Following cardiopulmonary bypass (CPB), blood remaining within the bypass machine circuit is
normally processed by a centrifugal separation of fluids from red blood cells (RBCs) and the
RBCs are reinfused back into the patient. An FDA approved device, the HemobagTM, provides an
alternative by reinfusing whole blood, including RBCs, from the CPB machine circuit. This
allows the patient’s own whole blood to be returned back to the patient with all components
including functioning, non-activated platelets, coagulation factors and plasma. In
preliminary human trials, blood measurements were improved in patients whose CPB blood was
processed through the HemobagTM.
This study will evaluate 50 patients whose post-CPB blood is processed by normal practice
(centrifugal separation of RBCs for reinfusion) or HemobagTM whole blood reinfusion. Outcome
measurements will be chest tube drainage for the initial 24 hours following on-pump cardiac
surgery, ventilatory requirements, protein levels, transfusion requirements, coagulation
profile, A/A gradients, arterial blood gas measures, and CBC blood panels. All of these data
are available from the normal clinical care of the patient.
The hypothesis is that the HemobagTM treated patients will have improved physiologic
function from the return of whole blood rather than just RBCs following cardiac surgery
using CPB.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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