[The determinant factors for open heart surgery with non-blood transfusion--analysis by quantitative theory class II]

The serious complications in the field of cardiovascular surgery are the blood transfusion related problems such as post transfusion hepatitis, AIDS, GVHD and immunosuppressed conditions. These problems have not been settled so far. In our department, open heart surgery with non-blood transfusion is the final goal and extracorporeal circulation with non-blood priming has been indicated under normal conditions. However depending on the cases, blood transfusion is definitely required. Under such circumstances, we analyzed the determinant factors as to whether open heart surgery with non-blood transfusion may be indicated or not, according to the formula based on the quantitative theory (class II). Extracorporeal circulation with non-blood priming were indicated on 124 patients in our department, and they were divided into two groups; blood transfusion group (group I): 64 patients, and non-blood transfusion group (group II): 60 patients. These two groups were compared for study in terms of age, preoperative weight, the body surface area, preoperative Ht value, calculated Ht value at the start of extracorporeal circulation, the aortic cross-clamping time, the total extracorporeal circulation time and total bleeding amount. The following are described in the order of importance. 1) Calculated Ht value: more than 30%. 2) The amount of blood loss after ECC is removed: less than 500 ml. 3) Preoperative body weight: more than 50 kg. 4) Preoperative Ht value: more than 40%. 5) The total ECC time: less than 90 min. In addition, prospective factors which should be considered preoperatively are determined in the following orders. 1) Calculated Ht value. 2) Preoperative Ht value. 3) Preoperative body weight.(ABSTRACT TRUNCATED AT 250 WORDS)