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Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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Blood Products Utilization Status in Off-Pump Cardiac Surgery Patients.

Azita Chegini1, Mastaneh Alaei1, Afsaneh Jahangiryan1

  • 1Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.

International Journal of Hematology-Oncology and Stem Cell Research
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Off-pump coronary artery bypass (OPCAB) surgery still shows high blood transfusion rates in Iran. Female sex, hypertension, and low hemoglobin predict the need for transfusions, with the ICU using the most blood products.

Keywords:
Blood transfusionCardiac surgical procedureCoronary artery bypassOff-pump

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Area of Science:

  • Cardiovascular Surgery
  • Transfusion Medicine
  • Healthcare Management

Background:

  • Transfusion support is critical in coronary artery bypass graft (CABG) procedures.
  • Off-pump coronary artery bypass (OPCAB) is a safe alternative to on-pump CABG (ONCAB), potentially reducing blood transfusions.
  • Varied transfusion practices necessitate an evaluation of transfusion patterns in OPCAB.

Purpose of the Study:

  • To assess transfusion rates and identify triggers for blood product use in OPCAB patients.
  • To analyze demographic and clinical factors associated with transfusion requirements in OPCAB surgery.
  • To determine which hospital departments have the highest blood product consumption post-OPCAB.

Main Methods:

  • Retrospective review of medical records for 91 elective OPCAB patients from 2014.
  • Extraction of patient demographics, preoperative lab tests (PT, aPTT, Hb, Hct, Platelet count), and medical conditions.
  • Statistical analysis using SPSS, including T-student, One Way Anova, and Chi-squared tests (P≤0.05 significance).

Main Results:

  • 69.23% of OPCAB patients received blood products, with mean utilization of 2.17 units PRBC, 2.46 FFP, 2.86 Platelets, and 0.40 Cryoprecipitate.
  • The Intensive Care Unit (ICU) showed the highest consumption for all blood products.
  • Predictive factors for transfusion included female sex (p<0.001), hypertension (P=0.002), and low hemoglobin (P=0.004).

Conclusions:

  • The transfusion rate in OPCAB surgery in Iran remains high, even in a regional hospital setting.
  • Female sex, hypertension, and preoperative low hemoglobin levels are significant predictors of transfusion needs.
  • ICU is the primary site for blood product utilization following OPCAB procedures, indicating a need for optimized transfusion protocols.