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Autotransfusion of shed mediastinal blood after open heart surgery
Kangli Zhao1, Jianping Xu, Shengshou Hu
1Department of Cardiac Surgery, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100037, China. KangliKangli@prodigy.net
Insights
Autotransfusion of shed mediastinal blood after open heart surgery is safe and effective. This method reduced the need for banked blood by 40% in patients undergoing coronary artery bypass grafting.
Area of Science:
- Cardiovascular Surgery
- Transfusion Medicine
Background:
- Open heart surgery, particularly coronary artery bypass grafting (CABG), often involves significant blood loss.
- Allogeneic banked blood transfusions carry inherent risks and are costly.
Purpose of the Study:
- To evaluate the safety and efficacy of autotransfusion of shed mediastinal blood post-open heart surgery.
- To compare the outcomes of autotransfusion versus standard banked blood transfusion in CABG patients.
Main Methods:
- A randomized controlled trial involving 60 patients undergoing CABG.
- Group 1 (n=30) received non-washed shed mediastinal blood autotransfusion.
- Group 2 (n=30) received standard banked blood transfusion. Hemoglobin, hematocrit, and platelet levels were monitored, and blood loss was quantified.
Main Results:
- No significant differences were observed in hemoglobin, hematocrit, or platelet counts between groups.
- Mean blood loss within 24 hours post-operation was similar in both groups.
- Patients receiving autotransfusion required 40% less banked blood compared to the control group.
Conclusions:
- Autotransfusion of shed mediastinal blood is a safe and effective practice following open heart surgery.
- This technique significantly reduces the reliance on allogeneic blood transfusions, offering a potential cost-benefit.
Objective:
To determine the safety and effectiveness of autotransfusion of shed mediastinal blood after open heart surgery.
Methods:
Sixty patients undergoing coronary artery bypass grafting (CABG) were selected randomly to receive either nonwashed shed mediastinal blood (Group 1, n = 30) or banked blood (Group 2, n = 30). Drainage and transfusion volume were determined after the operation. Hb, RBC, HCT and PLT were detected immediately before and after the operation, as well as 24 hours and 7 days after the operation. Data were analyzed using Fisher's exact test. A P < 0.05 was considered significant.
Results:
There were no significant differences in Hb, HCT, PLT or length of cardiopulmonary bypass (CPB) (P > 0.05). In the two groups, no significant difference in the mean blood loss was observed during 24 hours after the operation (660 +/- 300 ml in Group 1 and 655 +/- 280 ml in Group 2, P > 0.05). In Group 1, the mean volume autotransfused was 280 +/- 160 ml, and the patients required 360 +/- 80 ml banked blood compared with 660 +/- 120 ml in Group 2. In other words, the banked blood requirement in Group 1 was 40% lower.
Conclusions:
Autotransfusion of shed mediastinal blood after an open heart operation is safe and effective.
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