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Item Information   Holdings       More by this author     Murad, Tarek.     Subjects     Blood -- Transfusion, Autologous     Drainage, Surgical     MSP Thesis.     Browse Catalog     by author:      Murad, Tarek.       by title:      Evaluation of the sa...         MARC Display

Evaluation of the safety of chest tube drainage reinfusion / by Tarek Murad. by Murad, Tarek. Subjects Blood -- Transfusion, Autologous   Drainage, Surgical   MSP Thesis. Description:  iv, 45 leaves : ill. ; 28 cm. Contents:  Committee members: Dr. Charles Tritt, Dr. John Gassert, Dr. Vincent Canino. Introduction -- Materials and methods -- Results -- Summary -- Appendices: A. Instructions for authors -- B. Data collection protocol -- C. Table for pulmonary shunt fraction data -- D. Table for red blood cell data -- E. Table for pulmonary vascular resistance data -- F. Table for oxygen index data -- G. Table for white blood cells data -- H. Table for arterial-venous difference data -- I. Raw data. The reinfusion of patients' chest tube drainage (CTD) is a technique advocated for decreasing the use of donor blood in cardiac surgery. Contraindications for this procedure include coagulopathy, systemic infection, contamination of shed blood, renal failure, and malignancy. Shed mediastinal blood is generally neither concentrated nor washed and is characterized by having high granulocytes, low hematocrit (20-25%), dysfunctional platelets, high concentrations of anaphylatoxin (C3a) and high fibrinolytic activity. This prospective study was designed to compare the respective effects of lipid/leukocyte filtered and unfiltered shed mediastinal blood transfusion on pulmonary shunt fraction and the inflammatory response. The collected blood was reinfused to the patient within four hours of initiating collection. Thirty patients undergoing elective cardiac surgery were randomly assigned to a lipid/leuko-reducing group or a control group. In the lipid/leuko-reducing group (n=15) all collected blood was filtered by a lipid globule, C3a, and leukocyte-reducing filters. In the control group (n=15) all collected blood was filtered by a 20 μm microaggregate screen filter. The lipid/leuko-reduced group showed a significant decrease in pulmonary shunt fraction (p<0.05) following reinfusion, where the control group did not (p>0.05). In addition, the lipid/leuko-reduced group showed a trend towards decreased pulmonary vascular resistance, but this trend was not statistically significant. The level of red blood cells did not show a measurable increase after reinfusion of the CTD; the suspected reason for this was the low volume of CTD returned to the patients in this study. The study shows that the negative effects of lipids and leukocyte activation in the chest tube blood can be reduced using filtration. These results suggest that lipid/leuko-reducing chest tube blood improves pulmonary function, and is safe when reinfusing chest tube blood.   Copy/Holding information Location Collection Call No. Status   Walter Schroeder Library Master's Theses AC805 .M87 1998 Available Add Copy to MyList Format: HTMLPlain textDelimited Subject:   Email to:

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