1. Karounka Keita M.S.
Healthcare is always striving to better service the growing patient
population, through cutting cost and offering the best technology
possible to improve patient outcomes. In an effort to combat the
rising cost of Allogenic blood transfusion during surgery and the
increased length of hospital stay, due to infection secondary to
transfusion, we have elected to use the Hemobag as a solution to
this growing problem.
Define
1. Jean-Louis Vincent. Fluid management: the pharmacoeconomic dimension. Critical
Care. 2000, 4(Suppl 2):S33-S35.
2. Bamboat Z.M, Bordeianou L. Perioperative Fluid Management. Clin Colon Rectal
Surg. 2009 ; 22(1): 28–33
3. Shields C J. Towards a new standard of perioperative fluid management. Ther Clin
Risk Manag. 2008;4(2):569–571
4. Edmundas Sirvinskas, Tadas Lenkutis et al. Influence of residual blood
autotransfused from cardiopulmonary bypass circuit on clinical outcome after cardiac
surgery. Perfusion. 2005 Mar;20(2):71-5.
References
Analyze
Goal
Reduce the use of allogeneic blood products used
during cardiopulmonary bypass by 60% in the next
twelve months and then a further 30% by the end
of two year using a Hemobag.
Design
Conclusion
Improvement
Use of the Hemobag not only reduces the overall cost to the
patient, but also eliminates the high risk associated with an
allogenic blood transfusion. Since the patient is receiving
their own blood, the risk of rejection, as well as infection
goes down drastically. This corresponds to a decrease in
length of stay and the amount of medical materials used.
Conversely, the ability to see and treat new patients
increases; as a result of the decreased likely hood of
exposure while in the hospital setting. The Hemobag is a
safe, affordable and smart investment. It combines low cost
with patient safety and that is optimal for a hospitals needs.
.
Test Tolerance:
Continuous data collection on surgeries being used
with a Hemobag protocol and surgeries not using
Hemobag protocol.
Further Research:
Analyze cardiovascular surgeries that commonly
have high blood loss associated with them and how
the Hemobag can be advantageous in those type of
situations.
*Collection of as much blood as possible to
reinfusion in patient at a later time.
Design Modifications:
To continue to progress in the ever changing field
of healthcare, research is being conducted to
improve the performance of the Hemobag.
*Faster processing times of autologous blood.
Over the course of 6 months we evaluated a total of 200
hundred patients undergoing CABG and MVR surgeries
under the care of the same surgeon.
Data:
- Group 1=(n=100) patients followed current protocol
(transfusions given)
-Group2= (n=100) patients followed new Hemobag
protocol (no transfusion) unless absolutely needed.
Monitored:
*(A) Post operative bleeding,
*(B) Infection
*(C) Hospital length of stay.
*(D) Blood (ml) used
Results:
Group(2) Group(1)
A) 5% 37%
B) 2% 26%
C) 10 days 29 days
D) 100units 300units
Conclusion:
Patients receiving autologous blood on average showed a
lower percentage in hospital stay, infection rate and post
operative bleeding.
Hospital Study
Study:
Three patient groups
–1) 37 patients, all received residual blood after CPB
–2) 45 patients, no residual blood
–3) 42 patients, processed RBC from circuit
Discussion:
Lower infection rates = lower hospital stays
–Activated inflammatory factors, leukocytes, heparin,
hemolytic particles eliminated, Hct increase.
Post-op autotransfusion resulted in:
–Reduced donor blood transfusions
--Shorter hospital length of stay
Results & Current Research (4)
Due to the new screening guidelines for blood
donors and the genetic variability of individuals
becoming more complex, the donor blood
applicant pool is thinning. This limiting of
resource is increasing cost and making this vital
organ difficult to obtain.
Allogenic blood also comes with a high risk,
some of which include infection, which results in
longer hospital stays and treatment for patients.
Measure
-Standard Hemobag Circuit
Hemobag was an effective tool in minimizing the use of blood products
given during cardiovascular surgery, by 75 % in a six month period. It has
also reduced cost to the patient by 92% due to limited time spent in the
hospital.
Blood Cost
Cost:
1 unit of blood=500.00