[jbp0529]

Just wondering if there are other units out there that routinely use cardioPAT for autotransfusion after cardiovascular surgery. I've only seen it a few times, and it has been when there was significant blood loss, but lately it seems like more of our pts come back on it...I guess the docs like it bc of the fewer potential risks of transfusing the pt's own blood. Any thoughts?

Jim

[TopherSRN]

Not familar with CardioPAT, but we autotransfuse. Not a fan of it because it often is of little value other than volume. The cells contained it it are largely useless and it often causes more problems in a bleeder ( sometimes protentiates bleeding d/t containing active heparin etc.) If i need volume I'd much prefer Albumin, crystalloids or PRBCs. Hespan is they are not bleeding.

[ALCCRN]

I had to look up cardioPAT before I could respond, however, we routinely autotransfuse our patients after CABG. We used Pleura-Vac chest tubes with the autotransfusion bag. They had to meet certain criteria to autotransfuse, but from what i was taught, this isn't so much to replace lost blood, but to give volume. From what I found about the cardioPAT is that it is relatively new, widely available at the end of 2005. And it's the first of its kind to be able to go from OR to the unit. We used Cell Saver in the OR and then the PleuraVac Autotransfusion in the unit.

[ALCCRN]

I thought Hespan wasn't recommended after bypass anymore.....

http://dev.fffenterprises.com/web_pa...fo_story2.html

[TopherSRN]

That site only says during prime, on pump, and during decannulation. It is largely surgeon preference (1 of ours favors Hespan, others prefer Albumin). I won't give Hespan on a bleeder because it potentiates coaguopathy.



*The revised label (link below that paragraph) says not for use in those 3 periods because of the coagulopathy issues, but the risk of bleeding is diminished within hours. Doesn't address the post-op time period, and I'm never around a pt. in the first 3.

[MedicRN04]

I work in an 11 bed CSICU we are currently researching the CardioPat. We stopped auto-transfusing the atriums about 3-4 years ago and even then we only did it in an emergency with alot of blood loss. We have for years used the "Cell-Saver" in the OR however now we are connecting all of our 2-4 CT's to the CardioPat and processing it after each 4 hours reguardless of how much blood loss there has been. According to the rep the CardioPat processed blood contains 80% HCT as apposed to the 50% that the cell saver provided. We used one on a post op pt last week and proccessed 700mL of blood and it only gave us approx 80mL to transfuse. It's highly concentrated blood cells. We will be doing a long study to see if it truely cuts down on the need for blood bank PRBC transfusions. I'm sold already because it costs thehospital nothing, the machines are on loan and the company makes their money off the $500 set that take the place of the old atriums and with the atriums the blood was TRASHED the next day when the CT's were D/Ced so I can't see a negitive to these machines!!! Other than making the RN's learn a new piece of equiptment...LOL

[MedicRN04]

We use Albumin for volume now hespan is a thing of the past for us. Also with autotransfusing the atrium you are not only giving back HMG and HCT but also the irrigant and heparin used durring surgery. There is no filtering process for autotransfusion blood, do those of you who still do this use it with all pt's or only those with large volume of blood loss that are returning to the OR?