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Blood conservation during myocardial revascularization.

D M Cosgrove, R L Thurer, B W Lytle

    The Annals of Thoracic Surgery
    |August 1, 1979
    PubMed
    Summary
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    This study demonstrates that autologous blood salvage techniques significantly reduce the need for bank blood in coronary artery bypass surgery patients. Most patients received no allogeneic blood transfusions, highlighting the efficacy of intraoperative and postoperative blood recovery.

    Area of Science:

    • Cardiovascular Surgery
    • Transfusion Medicine
    • Anesthesiology

    Background:

    • Bank blood transfusions carry risks, including immunomodulation and disease transmission.
    • Coronary artery bypass grafting (CABG) is associated with significant blood loss, often necessitating allogeneic transfusions.
    • Minimizing allogeneic blood exposure is a key goal in cardiac surgery to improve patient outcomes.

    Purpose of the Study:

    • To evaluate the effectiveness of a comprehensive autologous blood salvage protocol in reducing bank blood use during elective CABG.
    • To assess the safety and feasibility of intraoperative and postoperative blood recovery techniques in cardiac surgery patients.

    Main Methods:

    • A prospective study involving 50 patients undergoing elective CABG.
    • Implementation of a multi-stage blood salvage system: pre-operative removal and reinfusion, intraoperative processing of discard suction, collection of pump oxygenator blood, and postoperative mediastinal drainage recovery.

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  • Acceptance of normovolemic anemia in stable patients.

    • Main Results:

    • The mean salvaged autologous blood volume was 259 ml intraoperatively and 194 ml postoperatively.
    • 94% of patients (47/50) received no bank blood or blood products during their hospital stay.
    • No bank blood was administered intraoperatively or within 24 hours post-operation.

    Conclusions:

    • Comprehensive autologous blood salvage is highly effective in eliminating the need for bank blood in elective CABG.
    • The implemented blood recovery techniques are safe and well-tolerated, with no complications attributed to the salvage methods.
    • This approach offers a viable strategy for blood conservation in cardiac surgery, potentially reducing transfusion-related risks and costs.