Autologous blood transfusion during cardiac surgery

Kaplan, Joel A.; CANNARELLA, CHARLES F.; Jones, Ellis L.; Kutner, Michael; Hatcher, Charles R.; Dunbar, Ronald W.

doi:10.1016/s0022-5223(19)41403-7

Cited by 84 publications

(9 citation statements)

References 10 publications

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“…Where specified, the lowest minimum Hb level allowed in enrolled patients was 10 g per dL; most studies specified 12 g per dL as a minimum for enrollment. Nearly all of the studies had extensive exclusion criteria that usually included recent myocardial infarction, coagulopathies, renal or hepatic disease, pulmonary dysfunction, low ejection fraction, or aortic stenosis, but five trials did not report any inclusion or exclusion criteria 26,28 , 32,37 , 38 …”

Section: Resultsmentioning

confidence: 99%

Preoperative acute normovolemic hemodilution: a meta‐analysis

Segal¹,

et al. 2004

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Section: Resultsmentioning

confidence: 99%

Preoperative acute normovolemic hemodilution: a meta‐analysis

Segal¹,

et al. 2004

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“…These large fluid shifts may cause changes in cardiac output and blood pressure. Also the method of blood collection may be important, and this can distract the anaesthetist or surgeon 6 • Our method is simple and involves only the perfusion personnel. The volume obtained, however, is not large, and the platelets and plasma proteins have already been diluted by the pump prime.…”

Section: Discussionmentioning

confidence: 99%

Maximal Conservation and Minimal Usage of Blood Products in Open Heart Surgery

Newland

Pastoriza-Pinol

McMillan

et al. 1980

Anaesth Intensive Care

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Open heart surgery has previously been associated with the use of large volumes of blood products. This paper describes methods of blood conservation and a simple method of intraoperative autotransfusion that together have resulted in minimal blood product usage in elective open heart surgery cases. This has reduced our dependence on blood bank supplies for the performance of elective open heart surgery.

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“…Seventeen trials of ANH (including five trials not cited in Fig. 5: Kaplan et al, 1977;Lilleaasen, 1977;Catoire et al, 1992;Welch et al, 1993;Van der Linden et al, 1994) provided data on the volumes of blood transfused. On average, the use of ANH resulted in a reduction of 1Á9 units of allogeneic blood per patient (95% CI 1Á1-2Á7 units).…”

Section: Acute Normovolaemic Haemodilutionmentioning

confidence: 99%

Autologous transfusion techniques: a systematic review of their efficacy

Carless

Moxey

O’Connell

et al. 2004

Transfusion Medicine

145

139

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Shortages of donor blood and fears of transmitted infections have prompted the use of a range of blood-sparing techniques in the peri-operative period. We conducted a systematic review of three techniques that involve the re-infusion of a patient's blood--pre-operative autologous blood deposit (PAD), acute normovolaemic haemodilution (ANH), and cell salvage (CS). We examined the effects of these interventions on the need for peri-operative allogeneic red blood cell transfusion and on clinical outcomes. Controlled clinical studies were identified by computer searches of comprehensive electronic databases and bibliographic searches of published articles. The literature search retrieved a total of 68 randomized trials (RCTs) and 81 controlled observational studies that included data from over 34 000 individuals. In summary, the RCTs found that autologous transfusion techniques consistently reduced the frequency of allogeneic transfusions, with intervention effect sizes ranging from a relative 63% reduction (95% CI 46-74%) with PAD, to 42% (27-53%) with CS and to 31% (16-44%) with ANH. Non-randomized studies reported larger effect sizes than RCTs. PAD increased overall transfusion rates by 30% (95% CI 12-48%) and reduced pre-operative haemoglobin levels by an average of 1.23 g dL(-1). Intervention effects were substantially reduced when these techniques were performed under transfusion protocols. Interpretation of the studies was hampered by serious methodological weaknesses, particularly inadequate randomization techniques, unblinded measurements and the subjective nature of the outcome variables. The studies reported few clinical outcome and adverse event data. Previous claims regarding reduced rates of mortality and infection with autologous transfusions were not confirmed.

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Autologous blood transfusion during cardiac surgery

Cited by 84 publications

References 10 publications

Preoperative acute normovolemic hemodilution: a meta‐analysis

Preoperative acute normovolemic hemodilution: a meta‐analysis

Maximal Conservation and Minimal Usage of Blood Products in Open Heart Surgery

Autologous transfusion techniques: a systematic review of their efficacy

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