The Effect of the Hemobag® Ultrafiltration System on Blood Conservation and Coagulation After Cardiopulmonary Bypass
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Purpose
This proposal is designed to mitigate hemodilution (blood diluted with an electrolyte solution) and loss of plasma proteins responsible for normal blood clotting as well as platelets at the completion of cardiopulmonary bypass (CPB). The Hemobag® system is a device qualified by the US Food and Drug Administration (FDA). Many cardiac centers, such as Englewood Hospital and Medical Center in Englewood NJ are using the Hemobag® system for Jehovah's witnesses and other patients who go to that center for bloodless cardiac surgery (cardiac surgery performed without the use of blood or blood products). The system is designed to filter excessive water from blood left in the heart lung machine (cardiopulmonary bypass) after it is separated from the patient during the performance of cardiac surgery. Consequently the likelihood of excessive post-operative bleeding and transfusion with allogeneic blood (blood bank blood from donors) is decreased.
| Condition | Intervention | Phase |
|---|---|---|
|
Blood Coagulation Disorders |
Device: method of returning residual CPB blood ( Hemobag®) |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | The Effect of the Hemobag® Ultrafiltration System on Blood Conservation and Coagulation After Cardiopulmonary Bypass |
- Chest catheter drainage [ Time Frame: Total amount for the first 24 hours postoperative ] [ Designated as safety issue: No ]Chest catheters are placed in the mediastinum and sometimes pleural space(s) to collect shed mediastinal blood in the first 24 hours post operative cardiac surgery
- Blood products transfused (RBC's, platelets, FFP) [ Time Frame: All blood products transfused during index admission, an expected average of 7 days, with the exception of preoperative transfusions. ] [ Designated as safety issue: No ]These blood components can be a metric of the success of achieving a satisfactory coagulation status.
- Acute kidney injury (AKI) [ Time Frame: All creatinines will be recorded and assessed during the entire index admission in order to compare postoperative to preoperative baseline creatinine, an expected average of 7 days. ] [ Designated as safety issue: No ]Using the AKIN definition (Acute Kidney Injury Network), serial postoperative creatinines will reflect the presence of AKI when compared with the baseline creatinine.
- Mortality [ Time Frame: 30 days postoperative ] [ Designated as safety issue: No ]Patients will be followed for 30 days post operative
- Stroke [ Time Frame: Index admission postoperative until the time of discharge, an expected average of 7 days. ] [ Designated as safety issue: No ]Any neurological defect according to Society of Thoracic Surgery (STS) definition
- Vasoactive drugs [ Time Frame: Any intravenous vasoactive drug being used at the 48 hour time point postoperative ] [ Designated as safety issue: No ]This metric is a surrogate for low output failure and /or vasoplegia depending upon whether inotropes or vasoconstrictors are used.
| Estimated Enrollment: | 100 |
| Study Start Date: | September 2011 |
| Estimated Study Completion Date: | November 2012 |
| Estimated Primary Completion Date: | September 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Hemobag®
Hemobag® method of returning residual CPB blood (study group)
|
Device: method of returning residual CPB blood ( Hemobag®)
The Hemobag® is a collection reservoir used to facilitate ultrafiltration of the CPB circuit after the patient has been disconnected from CPB).
Other Name: Hemobag®
|
|
No Intervention: cell saver
Standard method of returning the residual pump volume to the patient as washed, centrifuged cells (control group)
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
All adult cardiac surgery patients (age 18 or older) Cardiopulmonary bypass
Exclusion Criteria:
Patients under age 18 Off pump surgery
Contacts and Locations| Contact: Robert Kramer, MD | 2076622414 | kramer@mmc.org |
| Contact: Jane Conner-Kane, RN | 2076626991 | kanejan@mmc.org |
| United States, Maine | |
| Maine Medical Center | Recruiting |
| Portland, Maine, United States, 04102 | |
| Contact: Robert Kramer, MD 207-662-2414 kramer@mmc.org | |
| Principal Investigator: Robert Kramer, MD | |
| Principal Investigator: | Robert Kramer, MD | Maine Medical Center |
More Information
No publications provided
| Responsible Party: | Robert Kramer, MD, Director of Research and Quality Improvement Division of Cardiothoracic Surgery, Maine Medical Center |
| ClinicalTrials.gov Identifier: | NCT01435304 History of Changes |
| Other Study ID Numbers: | IRB # 3914 |
| Study First Received: | September 9, 2011 |
| Last Updated: | October 4, 2011 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Blood Coagulation Disorders Hemostatic Disorders Hematologic Diseases |
Vascular Diseases Cardiovascular Diseases Hemorrhagic Disorders |
ClinicalTrials.gov processed this record on May 16, 2013