Bloodless cardiac surgery utilizing a new low-prime oxygenator

Area of Science:

• Cardiovascular Surgery
• Transfusion Medicine
• Anesthesiology

Background:

• Homologous blood transfusions carry risks and increase healthcare costs.
• Minimizing allogeneic blood use in cardiac surgery is a significant clinical goal.

Purpose of the Study:

• To evaluate a prospective protocol for reducing homologous blood utilization during open-heart surgery.
• To assess the safety and efficacy of the protocol in a diverse patient cohort.

Main Methods:

• Implementation of a protocol focusing on surgical hemostasis, normovolemic hemodilution, and intraoperative blood salvage.
• Utilization of the Bentley BOS-10 Spiraflo oxygenator.
• Prospective enrollment of 100 consecutive open-heart surgery patients.

Main Results:

• All patients were successfully weaned from cardiopulmonary bypass without requiring blood transfusions.
• 80 patients completed surgery, and 60 were discharged from the ICU without homologous blood or derivatives.
• Mean blood usage was 1.32 units/patient, including reoperations for bleeding, with no significant complications.

Conclusions:

• The developed protocol effectively minimizes homologous blood requirements in open-heart surgery.
• The strategy is safe and feasible across various cardiac surgical procedures.
• This approach offers a viable alternative to routine blood transfusions, enhancing patient safety and resource management.