A SIMPLE WAY TO DECREASE HOMOLOGUOUS BLOOD USE IN CORONARY ARTERY SURGERY

Hasan KARABULUT, Fevzi TORAMAN, Cem ALHAN, Sümer TARCAN, Sinan DAĞDELEN, Nevnihal EREN, Nuri ÇAĞLAR

Acıbadem Hastanesi, Kalp Damar Cerrahisi Departmanı, İSTANBUL

Although many techniques and drugs emerge to decrease homologuous blood use in cardiac surgery transfusion still causes increased morbidity and cost. The aim of this study was to search for the efficacy of retransfusing the volume remaining in the extracorporeal circuits after the cardiopulmonary bypass. 100 consecutive patients undergoing isolated CABG were prospectively randomized into placebo (n=50) and retransfusion (n=50) groups. In retransfusion group, patients received the volume remaining in the extracorporeal circuits shortly after the termination of CPB. Differences in transfused blood and blood products were analyzed using Pearson chi-square test. Analyses of other variables were performed using an independent t-test.

Patients younger than 70 years old with a hemoglobin level of 7 gr/100 ml or less, and patients over 70 years with a hemoglobin level of 8 gr/100 ml or less received blood transfusion through out the study. The volume retransfused to the study group was 597±77.8 ml with a mean hematocrit value of 26.3±3.5 %. There were no deaths. No patients needed re-expoloration for bleeding. There were no post-operative complications. 46 patients (92%) did not receive any blood or blood products and 4 patients (8%) needed only 1 unit of homologous red cell transfusions in retransfusion group; whereas 13 patients (26%) needed 1 unit and 3 patients received 2 units of homologous red cell transfusions in control group (p=0.008). At discharge, the mean hematocrit value was statistically higher in retransfusion group compared with the control group. There was an important reduction in blood usage with the use of this nonpharmacological, simple, inexpensive, and safe method of blood conservation.

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