ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
AUTOLOGOUS BLOOD TRANSFUSIONS DURING THE BYPASS AND VALVE OPERATIONS
Mukadder Demirok, Demet Aşkın, İlter Emin
VKV. Amerikan Hastanesi, Kardiyak Anesteziyoloji Kliniği, İstanbul
Background: The main purpose of this study was to use autologous blood transfusion (ABT) during the Bypass and valve operations to decrease the allogenic blood transfusions.

Methods: Hundered patients scheduled for elective open heart surgery and their preoperative hematocrit values were over 35%. They were randomized to two group of 50 patients each. One of them was autotransfusion group (study group) and the other was control group (control group). After the surgery began, artery and vein grafts were ready 4 mg/kg IV heparin was given, when ACT was over 200 sec, the aorta was cannulated. 15% to 20% of total blood was taken from where the aorta cannule joins with the oxygenator, over 10 minute time period. We quikly infused colloid in equal amounts to blood taken. When operation was completed and protamin was given, we began to infuse the autologus bloods to the study group. Hematocrit values were over 27% for two groups during the operation, therefore we did not infuse any allogenic blood in the ICU or in the ward.

Results: There was no statistical difference between the two groups in blood pressure, HR, operation time, pump time and bleeding. When we compare the Htc values; there were no differences between preoperative Htc values, during the bypass, Htc levels were significantly lower in the levels were higher in the study group. Prior to hospital discharge, Htc levels were higher in the control group (p < 0.05). Amount of allogenic blood transfusions during the operations was significantly higher in the control group (p < 0.001). There were only 4 patients in the study group who needed allogenic blood transfusions.

Conclusion: We found that autotransfusion in open heart surgery can significantly reduce the need for allogenic blood transfusions. This method reduces the risk of transfusion complications and is also more cost- effective.

Keywords : Coronary artery by-pass graft surgery, autotransfusions, acute normovolemic hemodilution
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