Intraoperative and Postoperative Blood Conservation in Cardiac Surgery

수술중 및 수술후 혈액보존법

  • Published : 1994.06.01

Abstract

In February 1991 I initiated a blood conservation program that included hemodilution, use of a cell conservation device to concentrate diluted blood from operative field and from mediastinal shed blood, acceptance of a minimal hematocrit level of 25% in stable patients, and strict avoidance of use of blood products without definitive indication. A retrospective study to evaluate the effects of blood conservation program was designed to compare the amount of homologous transfusion, hematologic data, and postoperative outcome in patients operated on before and after initiation of blood conservation program. Patient characteristics were not different between two groups, before[n = 18] and after[n = 42] initiation of the program. The significant decrease of homologous transfusion[5.2 vs 1.4 units] and the marked increase of nontransfused patients[none vs 57%] in experimental group were due to marked decrease in homologous transfusion during the operation[4.6 vs 0.7 unit]. I conclude that with strict intraoperative blood conservation program, cardiac patients can be operated on with minimal homologous transfusion.

Keywords

References

  1. Blood use in cardiac surgery Friedel,N.;Hetzer,R.;Royston,D.
  2. Ann Thorac Surg v.50 Blood conservation in cardiac surgery Scott,W.J.;Kessler,R.;Wernly,J.A.
  3. Ann Thorac Surg v.51 A new era in blood conservation Goodnough,L.T.;Geha,A.
  4. J. Thorac Cardiovasc Surg v.103 Efficacy, complications, and cost of a comprehensive blood conservation program for cardiac operations Scott,W.J.;Rode,R.;Castlemain,B.(et al.)
  5. Ann Thorac Surg v.27 Autotransfusion following cardiac operations: a randomized, prospective study Thurer,R.L.;Lytle,B.W.;Cosgrove.D.M.;Loop,F.D.
  6. Surg Forum v.10 A mechanism to eliminate the donor blood prime from the pump oxygenator Panico,F.G.;Neptune,W.B.
  7. J Thorac Cardiovasc Surg v.43 Hemodilution principle of hypothermic perfusion: a concept obviating blood priming Greer,A.E.;Carey,J.M.;Zuhdi,N.
  8. Surgery v.52 Open-heart operations with disposable oxygenators, 5 percent dextrose prime, and normothermia Cooley,D.A.;Beall,A.C.;Grondin,P.
  9. Chest v.68 The effects of phlebotomy, hemodilution and autologous transfusion on systemic oxygenation and whole blood utilization in open heart surgery Cohn,L.H.;Fossberg,A.M.;Anderson,W.P.;Collins,J.J.
  10. J Thorac Cradiovasc Surg v.75 Autotransfusion of shed mediastinal blood after cardiac surgery Schaff,H.V.;Hauer,J.M.;Bell,W.R.(et al.)