The effect of postoperative normovolaemic anaemia and autotransfusion on blood saving after internal mammary artery bypass surgery

Abstract

The efficacy of two blood conservation techniques in decreasing and in preventing the use of homologous blood products was retrospectively studied in 150 patients undergoing internal mammary artery bypass surgery. Patients were matched according to prebypass blood haemoglobin (Hb) content and body surface area and were allocated to one of three groups: in the patients of group 1 (n = 50), normovolaemic anaemia (NA) was accepted postoperatively (haematocrit [Hct] was accepted to a minimum level of 25%); the patients of group 2 (n = 50) were treated with postoperative autotransfusion (AT) of mediastinal shed blood and acceptance of NA. Group 3 (n = 50) contained control patients, not treated with NA or with AT (Hct was accepted to a minimum level of 30%). Patients of group 1 required 3.0 +/- 0.3 units of homologous blood products, but the patients of groups 2 and 3 received significantly more (p less than 0.01) units: 3.9 +/- 0.2 and 4.5 +/- 0.3 units. No donor blood products were needed in 36%, 9% and 5% of the patients in groups 1, 2 and 3 respectively. The net postoperative blood loss was similar in the groups: 1229 +/- 92 ml in group 1, 1098 +/- 74 ml in group 2 and 1243 +/- 72 ml in group 3. However, total blood loss (1982 +/- 135 ml), including the retransfused part (954 +/- 89 ml), was significantly larger (p less than 0.01) in group 2, than in groups 1 and 3.(ABSTRACT TRUNCATED AT 250 WORDS)

Does Hyperfibrinolytic Activity Occur During Cardiopulmonary Bypass from Blood Exposed to Pleural Surfaces?

“…When the blood was returned to the systemic circulation an immediate significant increase in these values was observed ( 13). Similar studies by other researchers have concluded that reinfusion of highly activated suctioned blood exacerbates wound bleeding, and they noted that high concentrations ofFDP in this blood may play a role in the observed impaired hemostasis (14,16,17,(26)(27)(28)(29)(30). In contrast, other studies have shown that an increased level of fibrinolytic activator and FDP in whole blood reinfusions has no clinically significant effect on the stimulation of systemic fibrinolytic activity.…”

Analysis of P 50 and oxygen transport in patients after cardiac surgery

“…Limitation of a fall in Ps0 after cardiac surgery should primarily be obtained by techniques limiting the transfusion of homologous erythrocytes [35][36][37]. In high risk patients, a fall in Ps0 could be limited by the transfusion of RBCs with a short storage time, or even of 2,3-DPGenriched blood cells [38].…”