Utilization of rapid-infuser devices for massive blood loss.

Rapid volume replacement for severe hemorrhage continues to challenge the clinician involved in the care of the patient suffering hemorrhagic shock. We report on the development and utilization of two rapid-infuser systems for volume replacement in critically ill patients presenting in extremis. We...

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Publicado en:Perfusion Vol. 20; no. 2; pp. 65 - 70
Autores principales: Stammers AH, Murdock JD, Klayman MH, Trowbridge C, Yen BR, Franklin D, Elmore J
Formato: research tables/charts Journal Article
Publicado: Sage Publications, Ltd. Mar2005
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Utilization of rapid-infuser devices for massive blood loss.
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          Stammers AH
          Murdock JD
          Klayman MH
          Trowbridge C
          Yen BR
          Franklin D
          Elmore J
        affil: Perfusion Department, Geisinger Medical Center, 100 North Academy Avenue, Danville, PA 17822-2015; ahstammers@geisinger.edu
      sug:
        subj:
          Cardiopulmonary Bypass Equipment and Supplies
          Cardiopulmonary Bypass Methods
          Hemorrhage Prevention and Control
          Shock, Hemorrhagic Prevention and Control
          Data Analysis, Statistical
          Descriptive Statistics
          Evaluation Research
          Pennsylvania
          Time Factors
          Human
      ab: Rapid volume replacement for severe hemorrhage continues to challenge the clinician involved in the care of the patient suffering hemorrhagic shock. We report on the development and utilization of two rapid-infuser systems for volume replacement in critically ill patients presenting in extremis. We have developed rapid-infusion circuits by using commercially available devices available at our institution. The primary pumping mechanism is either a centrifugal pump (Revolution--COBE Cardiovascular, Arvada, CO, USA), or the Myocardial Protection System (MPS Quest Medical, Allen, TX, USA), and offers advantages over commercially available devices. Both circuits consist of a cardiotomy reservoir, a cardioplegia delivery set, assorted tubing and connectors, and a heater-cooler system. Between January and October of 2003, 15 procedures were performed which utilized one of these two devices. There were nine ruptured aneurysms, five traumas and one radical nephrectomy. The rapid infusion time averaged 228.5 +/- 105.7 min where 10.4 +/- 9.4 L of autotransfusion volume was processed, with 3.9 +/- 4.2 L of red cell volume reinfused. The allogeneic blood products that were transfused included packed red blood cells and fresh frozen plasma, as well as 5% albumin. There were no intraoperative deaths and the rapid-infuser was considered lifesaving in all instances. Mechanical rapid infusion systems may be lifesaving when severe hypovolemia or hemorrhagic shock is encountered. While both devices are able to meet the requirements of rapid fluid replacement, the MPS offers the most safety features and has become the standard of care at our institution.
      pubtype: Academic Journal
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        tables/charts
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      ougenre: Article
    language: English
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