Reduction in blood loss and blood use after cardiopulmonary bypass with high-dose aprotinin versus autologous fresh whole blood transfusion

Vedrinne, C.; Girard, Claude; Jegaden, Olivier; Blanc, Pascale; Bouvier, H.; Ffrench, Patrick; Mikaeloff, P; Estanove, S

doi:10.1016/1053-0770(92)90149-2

Cited by 40 publications

(7 citation statements)

References 24 publications

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“…Although these results suggest that PANH is effective in reducing allogeneic blood transfusion, we identified [18][19][20]29,36,37,[39][40][41]44,45,47,50,63 …”

Section: Discussionmentioning

confidence: 68%

“…5 We speculate that these analyses were hampered by the small number of trials included in some subgroups. In our analysis, 14 of 37 trials were conducted in patients undergoing cardiac surgery, 8,9,18,19,23,[35][36][37]44,45,50,61,63,64 whereas only 1 trial was conducted in patients undergoing noncardiac thoracic surgery. 51 Stratification of the data by the type of surgery provided only limited information.…”

Section: Evidence Of Benefitmentioning

confidence: 99%

“…16,23,25,27,28,30,33,[38][39][40][41][42][43][44][45][46][47]49,50,55,[60][61][62][63]65 These 31 studies revealed that the units of perioperative allogeneic RBC transfusion was significantly decreased in the PANH groupcompared with the control group (WMD, −0.94 units; 95% CI, −1.27 to −0.61 units; P < 0.0001). The results are presented in the forest plot in Figure 3.…”

mentioning

confidence: 98%

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Preoperative Acute Normovolemic Hemodilution for Minimizing Allogeneic Blood Transfusion

Zhou¹,

Zhang

Wang

et al. 2015

Anesthesia &Amp; Analgesia

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“…Although these results suggest that PANH is effective in reducing allogeneic blood transfusion, we identified [18][19][20]29,36,37,[39][40][41]44,45,47,50,63 …”

Section: Discussionmentioning

confidence: 68%

Section: Evidence Of Benefitmentioning

confidence: 99%

mentioning

confidence: 98%

See 1 more Smart Citation

Preoperative Acute Normovolemic Hemodilution for Minimizing Allogeneic Blood Transfusion

Zhou¹,

Zhang

Wang

et al. 2015

Anesthesia &Amp; Analgesia

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“…[12,13,14] This may have been possible due to higher preoperative Hb levels as well as large body surface area in these patients. A few others have demonstrated that withdrawal of 5-8 mL/kg [15] or 400 mL [11] of blood was not effective. In India, the main cause of valvular heart disease is rheumatic fever, which affects children belonging to low socio-economic status who have poor nutrition.…”

Section: Discussionmentioning

confidence: 95%

“…In addition, the use of antifibrinolytics and autologous blood transfusion have also contributed to the decrease in transfusion requirements. [11] The efficacy of ANH is still controversial with some studies demonstrating the effectiveness of ANH in cardiac surgery. These have mostly been in patients undergoing coronary artery bypass grafting in whom large volume of autologous blood (700-1000 mL) was withdrawn.…”

Section: Discussionmentioning

confidence: 99%

Acute normovolemic hemodilution is not beneficial in patients undergoing primary elective valve surgery

et al. 2010

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The objective of this study was to evaluate the effectiveness of acute normovolemic hemodilution (ANH) as a sole method of reducing allogenic blood requirement in patients undergoing primary elective valve surgery. One hundred eighty eight patients undergoing primary elective valve surgery were prospectively randomized into two groups: Group I (n=100) acted as control and in Group II (n=88) autologous blood was removed (10% of estimated blood volume in patients with hemoglobin (Hb) > 12g% and 7% when the Hb was < 12g%) in the pre-cardiopulmonary bypass (CPB) period for subsequent re-transfusion after protamine administration. The autologous blood withdrawn was replaced simultaneously with an equal volume of hydroxyl-ethyl starch solution. Banked blood was transfused in both the groups when Hb was < or = 6g% on CPB and < or = 8g% after CPB. Platelets were transfused when the count fell to < 100 x 10(9)/L and fresh frozen plasma (FFP) was transfused whenever there was diffuse bleeding with laboratory evidence of coagulopathy. The two groups were comparable as regards demographic data, type of surgical procedures performed, duration of CPB and ischemia, duration of elective ventilation and re-exploration for excessive bleeding. The autologous blood withdrawn in patients with Hb > or = 12g% was 288.3+/-69.4 mL and 244.4+/-41.3 mL with Hb < 12g% (P=NS). The Hb concentration (g%) was comparable pre-operatively (Group I = 12.1+/-1.6, Group II = 12.4+/-1.4), on postoperative day 1 (Group I = 10.3+/-1.1, Group II = 10.6+/-1.2) and day 7 (Group I = 10.9+/-1.5, Group II = 10.4+/-1.5). However, the lowest Hb recorded on CPB was significantly lower in Group II (Group I = 7.7+/-1.2, Group II = 6.7+/-0.9, P < 0.05). There was no difference in the chest tube drainage (Group I = 747.2+/-276.5 mL, Group II = 527.6+/-399.5 mL), blood transfusion (Group I = 1.1+/-1.0 units vs. Group II = 1.3+/-1.0 units intra-operatively and Group I = 1.7+/-1.2 units vs. Group II = 1.7+/-1.4 units post-operatively) and FFP transfusion (Group I = 581.4+/-263.4 mL, Group II = 546.5+/-267.8 mL) in the two groups. We conclude that low volume autologous blood pre-donation does not seem to provide any added advantage as a sole method of reducing allogenic blood requirement in primary elective valve surgery.

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Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion

Henry¹,

Moxey²,

Carless³

et al. 1999

The Cochrane Database of Systematic Reviews

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260

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Reduction in blood loss and blood use after cardiopulmonary bypass with high-dose aprotinin versus autologous fresh whole blood transfusion

Cited by 40 publications

References 24 publications

Preoperative Acute Normovolemic Hemodilution for Minimizing Allogeneic Blood Transfusion

Preoperative Acute Normovolemic Hemodilution for Minimizing Allogeneic Blood Transfusion

Acute normovolemic hemodilution is not beneficial in patients undergoing primary elective valve surgery

Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion

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