先天性心脏病心内直视手术对血浆内皮素的影响

目的　探讨先天性心脏病（ＣＨＤ） 围术期血浆内皮素（ＥＴ） 的变化。　方法　将６７ 例行心肺转流术（ＣＰＢ）的ＣＨＤ 患儿按疾病种类不同分为３ 组,室间隔缺损（ＶＳＤ） 组、肺动脉高压（ＰＨ） 组和肺动脉狭窄（ＰＳ） 组;１０ 例正常儿童为对照组。对前３ 组手术前后血浆ＥＴ 变化进行动态观测。　结果　ＰＨ 组和ＰＳ组术前ＥＴ 值即有升高,术后７ 天仍较对照组为高;ＣＰＢ３０ 分钟时各组ＥＴ 值均较术前为低;术前血浆ＥＴ 值与ＰＳ和ＰＨ 程度呈线性相关;ＰＳ组ＣＰＢ 时间和主动脉阻断时间与术后１ 小时ＥＴ 值明显相关。　结论　ＣＨＤ 患儿手术前、后血浆ＥＴ 值均有变化,血浆ＥＴ 水平可作为监测肺动脉压力变化及ＣＨＤ 手术预后的指标之一。     

急性中度等容性血液稀释对潘库溴铵量—效关系的影响

选择ＡＳＡＩ级行整形外科手术患者３０例随机分成两组：对照组（Ｃ）和血液稀释组（Ｈ）。在麻醉平稳后，手术开始前对Ｈ组患者行急性血液稀释达中度（血球压积平均２８．０４％）。试验中选用加速度仪的四个成串刺激（ＴＯＦ）形式监测神经肌肉功能，用小样本累积给药技术测定两组患者的潘库溴铵量-效关系的变化。结果表明：Ｃ组的潘库溴铵ＥＤ５０、ＥＤ９０、和ＥＤ９５、分别平均为２２．８５±６．９８、４５．２０±７．５１和４７．９９±７·６９μｇ／ｋｇ，Ｈ组的相应数值分别比Ｃ组增加了３２．４２％、２５．５５％和２５．１５％。急性中度等容性血液稀释使潘库溴争的量－效曲线有移，药效明显减弱。     

心脏瓣膜置换技术期间血液稀释及其对血流动力学的影响

采用Ｓｗａｎ－Ｇａｎｚ导管监测及动脉血血球压积（Ｈｃｔ）检测方法对２４例心脏瓣膜疾病人在施行瓣膜置换术期间的血液稀释（ＨＤ）情况及其对血流动力学的影响进行了研究。结果显示，ＣＰＢ开始前由于失血和输入晶体液，Ｈｃｔ有所降低。并因血容量不足ＣＩ下。ＣＰＢ期间Ｈｃｔ降至２５％左右，ＭＡＰ和ＳＶＲＩ也明显下降，３０ｍｉｎ后逐渐回升。ＣＰＢ结束后ＣＩ明显增高，Ｈｃｔ呈逐渐回增，术毕时达到麻醉前值的７８．６％     

深低温循环中断对血浆内源性洋地黄物质含量变化及对心肌超微结构的影响

实验犬１５只，随机分为三组。观察深低温循环中断不同时限（Ａ组３０分钟，Ｂ组６０分钟，Ｃ组８０分钟）及复温复跳后血浆内源性洋地黄物质（ＥＤＬＳ）变化和心肌超微结构的改变，结果表明，全组犬血浆ＥＤＬＳ在麻醉后即有所降低，转流前降至最低水平。Ｃ组在循环停止末期血浆ＥＤＬＳ显著增高，复温复跳后进一步升高，与ｐＨ、ＰＯ２显著的负相关。Ｃ组犬心肌超微结构明显损害。实验提示，心肌能耐受急性缺血缺氧仍以６０分钟为安全限度。ＥＤＬＳ急剧增高是重要脏器细胞遭受严重缺血缺氧损害的标志。     

高渗氯化钠对心钠素及内源性洋地黄样物质的影响

比较３０例硬膜外阻滞择期手术病人，输入７．５％ＨＳ和５％ＧＳ后血浆ＡＮＰ、ＥＤＬＳ及血流动力学的变化。输入ＨＳ后ＡＮＰ明显升高，ＥＤＬＳ短暂降低，６０ｍｉｎ完全恢复，主动脉顺应性快速增加。输入ＧＳ后ＡＮＰ有增加趋势，但无统计学意义。ＥＤＬＳ显著降低，６０ｍｉｎ时仅为基础值的。ＴＰＲ持续增加，ＣＯ和ＳＶ短暂降低，并伴有血压明显下降。揭示ＨＳ可明显刺激ＡＮＰ分泌，减缓ＥＤＬＳ变化。     

深低温循环中断对血浆内源性洋地黄物质含量变化及对心肌超

实验犬１５只，随机分为三组，观察深低温循环中断不同时限（Ａ组３０分钟，Ｂ组６０分钟，Ｃ组８０分钟）及复温复跳后血浆内源性洋地黄物质变化和心超微结构的改变，结果表明，全组犬血浆ＥＤＬＳ在麻醉后即有所降低，转流前降至最低水平。Ｃ组在循环停止末期血浆ＥＤＬＳ显著增高，复温复跳后进一步升高，与ＰＨ、ＰＯ２有显著的负相关。Ｃ组犬心肌超微结构明显损害。实验提示，心肌能耐受急性缺血缺氧仍以６０分钟为安全限度。Ｅ     

血液回收在脊柱侧弯矫正术中的应用价值

脊柱侧弯为小儿及青少年的常见病 ,行手术矫正内固定治疗时创伤非常大 ,出血很多。本文旨在探讨血液回收技术在脊柱侧弯矫正术中的应用价值。资料与方法一般资料　脊柱侧弯矫正ＴＳＲＨ内固定术患者 40例 ,ＡＳＡ为Ⅰ～Ⅱ级 ,年龄为 8～ 16岁 ,男 2 2例 ,女 18例 ,平均体重 45 6ｋｇ。方法　将 40例患者随机分为两组 ,每组 2 0例。术前均查血常规及出凝血时间。Ａ组 (对照组 ) :红细胞压积 (Ｈｃｔ)低于 0 30时输库血 ;Ｂ组 (血液回收组 ) :采用血液回收技术 ,利用ＣＯＢＥＢＲＡＴ2 血液回收系统将创面渗血吸引至血液回收机 ,在吸引的同…     

深低温停循环间断灌注脑保护液的实验研究

目的 研究深低温停循环（ＤＨＣＡ）间断灌注充氧脑保护液的脑保护效果及机制。方法 健康杂种犬１０条，Ａ组单纯ＤＨＣＡ１２０ｍｉｎ，Ｂ组ＤＨＣＡ后经双侧颈动脉间断灌注充氧脑保护液。两组动物于不同时相取皮层组织测定其三磷酸腺苷（ＡＴＰ）的含量及一氧化氮合酶（ＮＯＳ）的生，并作透射电镜（ＴＥ）检查。结果 ＤＨＣＡ１２０ｍｉｎ及恢复循环４５ｍｉｎ后，Ｂ组皮层组织ＡＴＰ的含量均明显高于Ａ组。Ａ组皮层组织还原型     

ESWL对机体凝血及纤溶系统的影响和钙拮抗剂的防护性作用

为了解ＥＳＷＬ后肾脏血管受损、机体血液状态改变情况及钙拮抗剂对其作用的影响，将３０只家兔随机分为两组，Ａ组未用异搏定，Ｂ组异搏定处理，观察ＥＳＷＬ前后血浆凝血纤溶参数的变化。Ａ组抗凝血酶Ⅲ（ＡＴ－Ⅲ）和纤溶酶原激活抑制物（ＰＡＩ）在ＥＳＷＬ后１～３天明显下降，纤维蛋白原降解产物（ＦＤＰ）和纤维蛋白原明显升高；Ｂ组仅纤维蛋白原和ＦＤＰ在ＥＳＷＬ后１、３天升高。提示ＥＳＷＬ后早期机体存在血液高凝、纤溶亢进状态，可能与肾损害有关，异搏定可纠正凝血和纤溶的平衡失调，改善血液状态，减轻肾损害     

心脏瓣膜置换术期间血液稀释及其对血流动力学的影响

采用Ｓｗａｎ－Ｇａｎｚ导管监测及动脉血血球压积（Ｈｃｔ）检测方法对２４例心脏瓣膜疾病病人在施行瓣膜置换术期间的血液稀释（ＨＤ）情况及其对血流动力学的影响进行了研究。结果显示，ＣＰＢ开始前由于失血和输入晶体液，Ｈｃｔ有所降低。并因血容量不足ＣＩ下降。ＣＰＢ期间Ｈｃｔ降至２５％左右，ＭＡＰ和ＳＶＲＩ也明显下降，３０ｍｉｎ后逐渐回升。ＣＰＢ结束后ＣＩ明显增高，Ｈｃｔ呈逐渐回增，术毕时达到麻醉前值的７８．６％。ＳＶＲＩ和ＭＡＰ于停机早期较低，后逐渐增高至接近正常值。ＣＰＢ前Ｈｃｔ与ＭＡＰ、ＭＰＡＰ、ＰＣＷＰ、ＰＶＲＩ、ＳＶＲＩ正相关，与ＣＩ负相关。ＣＰＢ中Ｈｃｔ与ＭＡＰ正相关。ＣＰＢ后Ｈｃｔ与ＭＡＰ、ＰＶＲＩ、ＳＶＲＩ、ＲＶＷＩ及ＬＶＷＩ正相关，与ＲＡＰ负相关。结果表明，心瓣置换木期间ＨＤ可通过多种机制影响血流动力学，尤对ＭＡＰ、ＳＶＲＩ及左、右心作功有重要影响。调整恰当的Ｈｃｔ是稳定循环的重要措施．     

Effect of autologous platelet-rich plasma (PRP) in cardiac surgery

Autologous platelet-rich plasma (PRP) was harvested before cardiopulmonary bypass (CPB). After heparin neutralization, it was returned to patients. The purpose of this study was to examine platelet function and the amount of blood loss and blood transfusion after transfusion of PRP. Twenty-eight patients undergoing elective coronary artery bypass grafting and other procedures were divided into three groups: group A; patients undergoing CAGB between May and October 1997 (n = 10), group B; patients undergoing other between May and October 1997 (n = 8), group C; patients undergoing CAGB before May 1997 (n = 10). Blood cell count, platelet aggregation in response to ADP, and platelet adhesion were measured before CPB, just after CPB, after infusion of protamine and PRP, 24 hrs after CPB and 48 hrs after CPB. Blood loss and blood transfusion in group. A and group C were examined after CPB. There was no significant difference in platelet count between group A and group B. There was significant difference in platelet aggregation in group A. There was no significant difference in blood loss after CPB between group A and group C, but there was a significant difference in blood transfusion between group A and group C. These results suggest that PRP was useful to preserve platelet function and to decrease blood loss after CPB in cardiac surgery.     

两种自体输血方式在中央性前置胎盘孕妇中应用的安全性分析

目的探讨储存式自体输血和急性等容稀释式自体输血在中央性前置胎盘孕妇剖宫产术中应用的安全性及临床疗效。方法选择2013年1月至2016年9月在我院因中央性前置胎盘拟行剖宫产术的60例患者为研究对象。采用随机数字表的方法平均分为两组:A组为储存式自体输血组,B组为急性等容稀释式自体输血组。观察两组患者自体输血采血前后及手术后的血红蛋白(Hb)、血细胞比容(Hct)、血小板计数(PLT)、术中出血量、输血量、新生儿Apgar评分及Hb水平、输血不良反应等。结果两组患者出血量及输血量比较无显著性差异(P0.05)。两组患者采血前后及手术后的Hb、Hct、PLT比较亦无显著性差异(P0.05)。两组新生儿1分钟Apgar评分及Hb水平比较无显著性差异(P0.05)。两组患者中输注自体血的患者均未发生输血不良反应,术后恢复良好;输注异体血的患者中,B组仅有1例出现发热、皮疹,未出现严重不良反应。结论储存式自体输血和急性等容稀释性自体输血在应用安全性上无明显差异。在基层医院临床工作中,针对中央性前置胎盘患者,由于剖宫产输血率高,可以在综合评估患者具体情况后,对必要的患者选择自体输血。     

Perflubron emulsion (AF0144) augments harvesting of autologous blood: a phase II study in cardiac surgery

OBJECTIVE: To assess tolerance and preliminary efficacy of a perfluorocarbon emulsion (AF0144) used with acute normovolemic hemodilution to reduce allogeneic blood transfusion for patients undergoing coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB). DESIGN: Controlled, single-blind, parallel-group phase II dose escalation trial. SETTING: Single-institution university medical center. PARTICIPANTS: Adult patients undergoing elective CABG surgery (n = 36). INTERVENTIONS: A calculated volume of autologous whole blood was harvested for each patient with a target on-bypass hematocrit of 20% to 22%. Placebo, low-dose (1.8 g/kg) AF0144, or high-dose (2.7 g/kg) AF0144 was infused. During CPB, blood was transfused at protocol-defined triggers (hematocrit <15%, PvO(2) <30 mmHg, SvO(2) <60%). After CPB, all autologous whole blood was reinfused. Allogeneic red blood cells were transfused if a trigger was reached. MEASUREMENTS AND MAIN RESULTS: Safety assessments (vital signs, hematology, blood chemistry, coagulation, and adverse events) were monitored through postoperative day 21. Efficacy endpoints included percentage of patients reaching a transfusion trigger and number of allogeneic units of red blood cells transfused. During CPB, <25% of subjects reached a transfusion trigger. During hospitalization, significantly fewer (p < 0.01) high-dose subjects (33%) reached a trigger than did control patients (91%). Allogeneic red blood cell transfusion did not differ significantly among groups. Safety assessments indicated AF0144 was well tolerated. CONCLUSION: The data suggest that AF0144 when used with acute normovolemic hemodilution is well tolerated and may be effective when used to enhance oxygen delivery for patients undergoing CABG surgery. Confirmation of safety and efficacy in a larger phase III clinical trial is warranted.     

The hemodynamics during hemodilution and its influence on the liver functions after hepatectomy for hepatocellular carcinoma with liver cirrhosis]

The hemodynamics during hemodilution occurred after hepatectomy for hepatocellular carcinoma with liver cirrhosis and its influences on the liver functions were studied. The hematocrit value gradually decreased about 10% until the 4th postoperative day owing to hemodilution after hepatectomy. While anemia progressed, cardiac index inversely increased. Under such a condition, oxygen consumption was maintained so that acidosis did not develop. Arterial blood ketone body ratio was also kept within a normal range except for a case whose hematocrit value decreased to 17.1%. Although the escaped hepatic enzymes such as GOT and GPT increased in the serum after hepatectomy, hemodilution was not responsible for their increase. While total bilirubin increased in the severe hemodiluted group, the increase was not due to hemodilution but caused by blood transfusion. The protein synthesis of the liver measured by rapid turnover protein levels in plasma was depressed after surgery, and this depression prolonged to the 14th postoperative day in the group whose hematocrit value decreased below 20%. These results suggest that it is better to keep hemodynamics without blood transfusion unless the hematocrit value decrease below 20%, and also better to maintain the hematocrit above 20% for liver regeneration after hepatectomy.     

Effects of hemodilution and phenylephrine on cerebral blood flow and metabolism during cardiopulmonary bypass

OBJECTIVE: Hypotension resulting from hemodilution on cardiopulmonary bypass is often treated by pressor (eg, phenylephrine) infusion. The effect of phenylephrine on cerebral blood flow (CBF) in this setting is not clear. It was hypothesized that phenylephrine might decrease CBF. MEASUREMENTS and MAIN RESULTS: Six different radioactively labeled microspheres (15 microm) were used to measure CBF at 6 time points (T) in 9 pigs (mean body weight 11.3 +/- 1.2 kg): T1 baseline before bypass (mean arterial pressure [MAP] 76 +/- 5 mmHg), T2 on mildly hypothermic CPB (34 degrees C, pump flow 100 mL/kg/min, hematocrit 30%, MAP 79 +/- 7 mmHg), T3 after moderate hemodilution with crystalloid (hematocrit 20%, resulting MAP 62 +/- 6 mmHg), T4 after phenylephrine administration to increase MAP to baseline values (hematocrit 20%), T5 after severe hemodilution (hematocrit 10%, resulting MAP 41 +/- 4 mmHg), and T6 after phenylephrine administration to normalize MAP (hematocrit 10%). In addition, blood flow to liver, small bowel and skeletal muscle, and pH of jugular venous blood were measured at each time point. After institution of CPB, the CBF (mL/min/100 g tissue) increased significantly to 53 +/- 9 (baseline levels 44 +/- 8, T1 v T2, p = 0.03). Hemodilution resulted in significant increases in CBF on CPB to 65 +/- 9 and 90 +/- 9 at hematocrit 20% and hematocrit 10%, respectively (T2 v T3, p = 0.03; T3 v T5, p = 0.01) and a progressive fall in jugular venous pH. At each level of hemodilution, phenylephrine resulted in an additional increase in CBF (T4, 74 +/- 8; T6, 108 +/- 12; T3 v T4, p = 0.04; T5 v T6, p = 0.01) but did not improve jugular venous pH. Changes in liver blood flow after hemodilution and vasopressor injection showed a similar pattern to CBF. However, the blood flow to small bowel and skeletal muscle increased with hemodilution but decreased significantly with phenylephrine administration. CONCLUSIONS: Phenylephrine redirects blood flow from the bowel and muscle to the brain and liver. Hemodilution increases CBF and pressor administration further increases CBF by elevating perfusion pressure. Maintenance of a higher hematocrit on CPB increases MAP and should decrease the need for vasopressor administration.     

Coagulation tests during cardiopulmonary bypass correlate with blood loss in children undergoing cardiac surgery.

OBJECTIVES: To examine whether coagulation tests, sampled before and during cardiopulmonary bypass (CPB), are related to blood loss and blood product transfusion requirements, and to determine what test value(s) provide the best sensitivity and specificity for prediction of excessive hemorrhage. DESIGN: Prospective. SETTING: University-affiliated, pediatric medical center. PARTICIPANTS: Four hundred ninety-four children. INTERVENTIONS: Coagulation tests. MEASUREMENTS AND MAIN RESULTS: Demographic, coagulation test, blood loss, and transfusion data were noted in consecutive children undergoing cardiac surgery. Laboratory tests included hematocrit (Hct), prothrombin time, partial thromboplastin time (PTT), platelet count, fibrinogen concentration, and thromboelastography. Stepwise linear regression analysis indicated that platelet count during CPB was the variable most significantly associated with intraoperative blood loss (in milliliters per kilogram) and 12-hour chest tube output (in milliliters per kilogram). Other independent variables associated with blood loss were thromboelastography maximum amplitude (MA) during CPB, preoperative PTT, preoperative Hct, and preoperative thromboelastography angle and shear modulus values. Thromboelastography MA during CPB was the only variable associated with total products transfused (in milliliters per kilogram). Of all tests studied, platelet count during CPB (< or = 108,000/microL) provided the maximum sensitivity (83%) and specificity (58%) for prediction of excessive blood loss (receiver operating characteristic analysis). Blood loss was inversely related to patient age; neonates received the most donor units (median, 8 units; range, 6 to 10 units). CONCLUSIONS: During cardiac surgery, coagulation tests (including thromboelastography) drawn pre-CPB and during CPB are useful to identify children at risk for excessive bleeding. Platelet count during CPB was the variable most significantly associated with blood loss.     

急性血小板分离回输对体外循环心脏直视手术患者的血液保护效果

目的 评价急性血小板(Plt)分离回输对体外循环(CPB)心脏直视手术患者的血液保护效果.方法 择期拟在CPB下行心脏直视手术患者30例,ASA分级Ⅱ或Ⅲ级,年龄41～63岁,体重52～72 kg.采用随机数字表法,将患者随机分为2组(n=15):对照组(C组)和急性Plt分离组(APP组).APP组在麻醉诱导后行APP,提取富Plt血浆,于CPB结束鱼精蛋白中和肝索后回输,C组不行APP.于麻醉诱导前、术后1、24和48h时记录Hb、Plt、PT、APTT及Fib.记录CPB时间、主动脉阻断时间、术后引流量和输血情况.结果 APP组急性Plt分离处理的全血容量为(1285±185) ml,采集富Plt血浆(192±38) ml,其中Plt计数(817±282)×10/L,占全身血容量Plt总数(21±3)％,Plt分离时间(35±10) min.与C组比较,APP组术后1h时Plt升高,术后24h内引流量、异体红细胞、Plt输注量和异体Ph输注率降低(P＜0.05或0.01),其余指标差异无统计学意义(P＞0.05).结论 急性Plt分离回输对CPB心脏直视手术患者具有血液保护作用.     

Experimental studies on artificial blood usage for hemodilution during cardiopulmonary bypass.

BACKGROUND: Although hemodilution is usually utilized during cardiopulmonary bypass (CPB), hemodilution can cause adverse effects such as hypotension and hypoxia. The purpose of this study was to evaluate a novel perfluoro-octyl bromide (PFOB) emulsion, one of perfluorochemicals (PFCs) emulsions, administered during hemodilution CPB. METHODS: Fifteen dogs were subjected to CPB for 2 hours under mild hypothermia. Animals were divided into three groups; control group, hemodilution group and PFOB group. During the experiment, hemodynamics, complete blood count and blood chemistry were monitored. In addition, serum complement titer (CH50), bradykinin and histamine concentrations were also measured. RESULTS: Heart rate (HR) was markedly elevated in the hemodilution groups (p<0.05). Mean arterial pressure (MAP) did not change in the three groups. White blood cell (WBC) and platelet (PLT) count did not significantly differ among the three groups. Plasma lactate concentration was markedly elevated only in hemodilution group during late phase of CPB (p<0.05). In the hemodilution group, CH50, bradykinin and histamine, were markedly elevated during the CPB and just after CPB (p<0.05). CONCLUSIONS: The present study demonstrated possible benefits of the new PFC emulsion during cardiac surgery by counteracting the adverse effects of hemodilution during CPB.     

Utility of whole blood hemostatometry using the clot signature analyzer for assessment of hemostasis in cardiac surgery

BACKGROUND: A hemostatic monitor capable of rapid, accurate detection of clinical coagulopathy within the operating room could improve management of bleeding after cardiopulmonary bypass (CPB). The Clot Signature Analyzer is a hemostatometer that measures global hemostasis in whole blood. The authors hypothesized that point-of-care hemostatometry could detect a clinical coagulopathic state in cardiac surgical patients. METHODS: Fifty-seven adult patients scheduled for a variety of elective cardiac surgical procedures were studied. Anesthesia, CPB, heparin anticoagulation, protamine reversal, and transfusion for post-CPB bleeding were all managed by standardized protocol. Clinical coagulopathy was defined by the need for platelet or fresh frozen plasma transfusion. The Clot Signature Analyzer collagen-induced thrombus formation (CITF) assay measured platelet-mediated hemostasis in vitro. The activated clotting time, platelet count, prothrombin time, activated partial thromboplastin time, and fibrinogen concentration were also measured. RESULTS: The postprotamine CITF was greater in patients who required hemostatic transfusion than in those who did not (17.6 +/- 8.0 min vs. 10.5 +/- 5.7 min, respectively; P < 0.01). Postprotamine CITF values were highly correlated with platelet and fresh frozen plasma transfusion (Spearman r = 0.50, P < 0.001 and r = 0.40, P < 0.005, respectively). Receiver operator characteristic curves showed a highly significant relation between the postprotamine CITF and intraoperative platelet and fresh frozen plasma transfusion (area under the curve, 0.78-0.81, P < 0.005) with 60-80% sensitivity, specificity, positive and negative predictive values at cutoffs of 12-14 min. Logistic regression demonstrated that the CITF was independently predictive of post-CPB hemostatic transfusion, but standard hemostatic assays were not. CONCLUSIONS: The Clot Signature Analyzer CITF detects a clinical coagulopathic state after CPB and is independently predictive of the need for hemostatic transfusion. Hemostatometry has potential utility for monitoring hemostasis in cardiac surgery.     

Evaluation of the Hemobag: a novel ultrafiltration system for circuit salvage

Following termination of bypass, the CPB circuit contains a significant volume of diluted blood. Various methods have been used to salvage this blood, including direct transfusion or centrifugation /washing of the circuit volume. These techniques produce a reinfusion product that is either dilute or free of plasma proteins. The purpose of this study is to evaluate the Hemobag ultrafiltration system, which may overcome these limitations. Yorkshire pigs (n = 4, approximately 40 kg) were placed on CPB (prime volume 1.5 L) for 60 min. Following CPB, control blood samples (Pre) were collected from the circuit. The circuit contents were then transferred into a Hemobag and processed. Blood samples (post) were then collected from the Hemobag. Pre- and post-samples were analyzed and compared using a Student's t-test. Parameters that were significantly different (p < .05) pre-Hemobag versus post-Hemobag were as follows: hematocrit 20.4+/-3.4% vs. 54.1+/-11.6%, total protein 2.4+/-0.4 vs. 8.2+/-2.9 gms/DL, fibrinogen 92.0+/-0.3 vs. 305.8+/-37.2 mg/DL. Parameters that were not significantly different but trended toward an increase post-Hemobag were platelet counts, heparin levels, white cell count, and plasma free hemoglobin. Parameters that showed no differences or trends included sodium, potassium, chloride, bicarbonate, and osmolarity. Processing times were measured at approximately 10 minutes. This device effectively concentrates post-bypass circuit volume, providing a product that is high in red blood cells and plasma proteins and may provide an alternative to current techniques for circuit volume salvage.