Ein alternatives Konzept fur den Blutersatz bei der Massivtransfusion

Background: Devices for massive transfusion must provide rapid infusion rates (at least 400 to 500 ml/min), warming, and preferably a reservoir which can be 'pre-loaded' in anticipation of rapid blood loss. However, many commercially available devices are associated with high; cost for disposable components. We describe an effective device with disposables cost of only approximately US$ 350. Methods: The unit is made up of a 5 l reservoir bag (MTSM®, MTK), a blood filter (Pall), an infusion pump with a pump rate of 165 ml/min (Intramat®, MSB) and a high-flow rate blood warmer (H250, Level 1® Technologies Inc.) (Fig. 1). The 5-l reservoir-bag has 3 inlets for blood bags on the upper end and 2 outlets for blood filters on the lower end. There is an additional line where an auto-transfusion device can be connected directly to the reservoir bag. This offers the opportunity to regain, if possible, intraoperative autologous erythrocytes and to wash the homologous erythrocytes. We use two units in parallel (one for erythrocytes, one for fresh frozen plasma), which can be conveniently connected to a large bore dual lumen catheter. The capital and disposable costs for each unit are US$ 10,000 and US$ 175, respectively. Results: Since years we have successfully used this device in operations in which massive transfusion was required. Conclusions: We have presented an effective device constructed of already available components, which allows the rapid infusion of blood products. The capital and operating costs are lower than most commercially available special devices.