Blood Conservation and Autotransfusion in Cardiac Surgery

Abstract

Blood conservation techniques of withdrawal of blood just before surgery, intraoperative blood salvage with Solcotrans (Solco Basle [UK] Ltd.), and profound hemodilution were used in 14 patients undergoing open heart surgery (group I) and compared with equally matched 14 patients who had profound hemodilution only during cardiopulmonary bypass (CPB) and acted as controls (group II). Group I patients required a mean of 255 mL of homologous blood per patient to achieve a target hemoglobin of 8 g/dL compared to group II patients who required a mean of 1,011 mL per patient (p = 0.0001). By using autologous blood there was a marked reduction in homologous blood exposure. Eight patients in group I and two patients in group II required no homologous blood. No adverse events occurred. In the process of conservation of blood in open heart surgery, we found the combination of the above techniques used in Group I patients to be safe and effective.

Acute normovolaemic haemodilution does not aggravate gastric mucosal acidosis during cardiac surgery

“…Several studies have demonstrated that the use of acute normovolaemic haemodilution with autologous blood transfusion reduces the transfusion rate of homologous packed red cells, fresh frozen plasma and platelet concentrates during cardiac surgery [1][2][3]. The blood-sparing effect of this technique is based on the fact that diluted blood is shed during surgery, when the greatest loss of intravascular fluid occurs.…”

“…Fig 2. Changes in gastric mucosal pH phi A, gastric mucosal carbon dioxide tension pi-CO 2 B, and the difference between arterial pH and pHi pHa -pHi C during the study period in the two study groups.…”