[HSF] Aprotinin

[Edward Bender]

1. Harvest vein, close the leg, and wrap loosely with Ace wrap prior  
to heparinization.
2. One lap pad for the entire case.  Rinse it frequently to harvest  
anything red.
3. Small and short pump tubing with no clear stuff in the venous limb.
4. Very low priming volume.
5. Meticulous hemostasis: the adage being "Dry on the way in, dry on  
the way out."
6. There are no statements that "this oozing should stop" accepted.
7. DDAVP
8. All red perfusate washed, spun, and given back to the patient.
9. Patients must pass the "2 minute test":  While the chest wound is  
being closed, after the wires are tightened, the mediastinal tube is  
connected to -20 cm suction.  If there is no "bloody show," this is a  
pass and the patient will not bleed post-op.  If the 2 minute test is  
not passed after several tries, the chest is re-opened and examined.   
I picked this up from Henry Sullivan formerly of Loyola Univ.  If the  
patient doesn't pass, the blood in the chest tube is suctioned back  
into the cell saver.

That's it.

Ed Bender, MD

On Sep 20, 2007, at 4:12 PM, MDavalle at aol.com wrote:

> I am impressed that you can take a female through an on pump case  
> with no
> blood and only drop 2 points of HCT. What measures do you use to  
> accomplish this?
> I am trying smaller pump primes, ultrafiltration during pump run,  
> cell saver
> , etc but not with as good  results as yours. Do you have any other  
> tips?
>
>
>
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