Intraoperative autotransfusion reduces blood loss after cardiopulmonary bypass

被引:57
作者
Kochamba, GS
Pfeffer, TA
Sintek, CF
Khonsari, S
机构
[1] Regl. Department of Cardiac Surgery, Los Angeles Kaiser Permanente M., Los Angeles, CA
[2] Regl. Department of Cardiac Surgery, Los Angeles Kaiser Permanente M., Los Angeles
关键词
D O I
10.1016/0003-4975(95)01155-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. A combination of several techniques is necessary to minimize the transfusion requirements for open heart operations. The benefit of plasmapheresis remains in doubt because of smaller and less effective platelets obtained with this technique. Therefore, we evaluated the effects of whole blood intraoperative autotransfusion as part of a blood conservation protocol. Methods. One hundred patients undergoing coronary artery bypass graft operations were randomized to an autotransfusion group (group A) or control group (group C). Group A patients had 10 mL/kg of whole blood removed before cardiopulmonary bypass; they had retransfusion at the termination of cardiopulmonary bypass and heparin reversal. Both groups had intraoperative cell saving and autotransfusion of shed mediastinal blood postoperatively. The indications for blood transfusion were standardized, and the physicians ordering blood products were blinded to the study. Results. Compared with the control group, patients in the autotransfusion group had a 28% reduction of chest tube drainage at 8 hours and a 45% reduction in the total homologous blood units transfused. Conclusions. Autotransfusion during cardiopulmonary bypass provides benefit in addition to other techniques in reducing blood loss and the need for blood products in the postoperative period.
引用
收藏
页码:900 / 903
页数:4
相关论文
共 12 条
[1]  
AUBUCHON JP, 1992, INCREASING SAFETY BL
[2]   AN IMPROVED TECHNIQUE FOR AUTO-TRANSFUSION OF SHED MEDIASTINAL BLOOD [J].
COSGROVE, DM ;
AMIOT, DM ;
MESERKO, JJ .
ANNALS OF THORACIC SURGERY, 1985, 40 (05) :519-520
[3]   ON THE NEED FOR IMPROVED TRANSFUSION INDICATORS IN CARDIAC-SURGERY [J].
GOODNOUGH, LT ;
DESPOTIS, GJ ;
HOGUE, CW ;
FERGUSON, TB .
ANNALS OF THORACIC SURGERY, 1995, 60 (02) :473-480
[4]  
HALLOWELL P, 1972, J THORAC CARDIOV SUR, V64, P941
[5]  
HUGGINS C, 1989, TRANSPLANT P, V21, P43
[6]   EFFECTS OF INTRAOPERATIVE PLASMAPHERESIS ON BLOOD-LOSS IN CARDIAC-SURGERY [J].
JONES, JW ;
MCCOY, TA ;
RAWITSCHER, RE ;
LINDSLEY, DA .
ANNALS OF THORACIC SURGERY, 1990, 49 (04) :585-590
[7]  
KAPLAN JA, 1977, J THORAC CARDIOV SUR, V74, P4
[8]   THE HEMOSTATIC EFFECT OF AUTOLOGOUS PLATELET-RICH PLASMA VERSUS AUTOLOGOUS WHOLE-BLOOD AFTER CARDIAC OPERATIONS - IS PLATELET SEPARATION REALLY NECESSARY [J].
MOHR, R ;
SAGI, B ;
LAVEE, J ;
GOOR, DA .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1993, 105 (02) :371-373
[9]   CONVENTIONAL BLOOD CONSERVATION TECHNIQUES IN 500 CONSECUTIVE CORONARY-ARTERY BYPASS OPERATIONS [J].
OVRUM, E ;
HOLEN, EA ;
ABDELNOOR, M ;
OYSTESE, R .
ANNALS OF THORACIC SURGERY, 1991, 52 (03) :500-505
[10]   REDUCTION OF HOMOLOGOUS BLOOD REQUIREMENTS BY BLOOD-POOLING AT THE ONSET OF CARDIOPULMONARY BYPASS [J].
PETRY, AF ;
JOST, T ;
SIEVERS, H .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1994, 107 (05) :1210-1214