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Use of the Hemobag for modified ultrafiltration in a Jehovah's Witness patient undergoing cardiac surgery
Authors:Moskowitz David M  Klein James J  Shander Aryeh  Perelman Seth I  McMurtry Kirk A  Cousineau Katherine M  Ergin M Arisan
Institution:Department of Anesthesiology, Critical Care Medicine, Pain Management and Hyperbaric Medicine, Englewood Hospital and Medical Center, 305 Engle Street, Englewood, New Jersey 07631, USA. david.moskowitz@ehmc.com
Abstract:Modified ultrafiltration is an important technique to concentrate the patient's circulating blood volume and the residual whole blood in the extracorporeal circuit post-cardiopulmonary bypass. The Hemobag system is a device cleared by the US Food and Drug Administration and represents a novel and safe modification of traditional modified ultrafiltration systems. It is quick and easy to operate by the perfusionist during the hemoconcentration process. Hemoconcentration is accomplished by having the Hemobag "recovery loop" circuit separate from the extracorporeal circuit. This allows the surgeons to continue with surgery, decannulate, and administer protamine simultaneously while the Hemobag is in use. The successful use of the Hemobag in a Jehovah's Witness patient has not been previously described in the literature. This case report describes how to set up and operate the Hemobag in a Jehovah's Witness patient undergoing cardiac surgery that requires an extracorporeal circuit.
Keywords:cardiopulmonary bypass  ultra-filtration  modified ultrafiltration  Jehovah’s Witness  blood conservation  blood management  blood salvaging
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