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European Journal of Cardio-Thoracic Surgery, Vol 4, 644-648, Copyright © 1990 by European Association for Cardio-thoracic Surgery
E Ovrum, E Am Holen and MA Lindstein-Ringdal
Restriction of donor blood transfusions in cardiac surgery should decrease
the risk of infective contamination and antigenicity. Following a simple,
systematic and inexpensive blood conservation program, we report on 250
consecutive patients undergoing elective coronary artery bypass surgery,
247 (98.6%) of whom did not need homologous blood transfusions. At least
one internal mammary artery was grafted in all but one patient, in
combination with saphenous vein grafts. Intraoperatively, autologous
heparinized blood was removed before bypass and retransfused at the
conclusion of extracorporeal circulation. The remaining volume of the
oxygenator and tubing set was retransfused without any cell processing or
hemofiltration. Using the hard-shell cardiotomy reservoir from the heart
lung machine, autotransfusion of the shed mediastinal blood was continued
hourly up to 18 h after surgery. The mean postoperative mediastinal
bleeding was 622 +/- 287 ml, of which 589 +/- 296 ml was autotransfused.
Five patients (2.0%) needed re-exploration for bleeding, and three of these
received 1-4 units of homologous blood. No other patients needed red cell
transfusions. Seven patients were given a mean of 2.6 units of fresh frozen
plasma because of coagulopathy. Thus, altogether 240 patients (96%) were
not exposed to any homologous blood products during their hospital stay.
Morbidity was low. At discharge, the mean hemoglobin concentration was 12.0
+/- 1.4 g/dl and the mean hematocrit 36.0 +/- 4.2%. There were no deaths.
ARTICLES
Coronary artery bypass surgery with minimal use of homologous blood. Effects of a simple and inexpensive blood conservation programme
Oslo Heart Center, Rikshospitalet, Norway.
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L. Sandrelli, A. Pardini, R. Lorusso, M. L. Sala, M. Licenziati, and O. Alfieri Impact of Autologous Blood Predonation on a Comprehensive Blood Conservation Program Ann. Thorac. Surg., March 1, 1995; 59(3): 730 - 735. [Abstract] [Full Text] |
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