The Journal of extra-corporeal technology
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J Extra Corpor Technol · Dec 2017
TEG-Directed Transfusion in Complex Cardiac Surgery: Impact on Blood Product Usage.
Complex cardiac procedures often require blood transfusion because of surgical bleeding or coagulopathy. Thrombelastography (TEG) was introduced in our institution to direct transfusion management in cardiothoracic surgery. The goal of this study was to quantify the effect of TEG on transfusion rates peri- and postoperatively. ⋯ TEG-directed management of blood product administration during complex cardiac surgeries significantly reduced the units of blood products received perioperatively but not blood usage more than 24 hours after surgery. Overall, fewer patients were exposed to allogenic blood. The use of TEG to guide blood product administration significantly impacted transfusion therapy and associated costs.
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J Extra Corpor Technol · Dec 2017
Quantification of Carbon Dioxide Removal at Low Sweep Gas and Blood Flows.
Advancement in oxygenator membrane technology has further expanded the boundaries in the clinical application of extracorporeal carbon dioxide removal (ECCO2R). Despite the advent of modern poly-4-methyl-1-pentene (PMP) membranes, limited information exists on the performance of these membranes at low sweep gas and blood flows. Moreover, physiological relationships for CO2 removal at these flows are less explored. ⋯ At these test parameters, an increase in sweep gas improved the CO2 transfer, whereas an increase in blood flow resulted in a lower CO2 transfer. These results indicate that CO2 removal in low-flow ECCO2R is mainly sweep gas flow driven. Although these settings might not be applicable for clinical use, this study gives tangible information about the important factor involved in ECCO2R.