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Autotransfusion of shed mediastinal blood after cardiac surgery: a prospective study
Insights
Autotransfusion of shed mediastinal blood after cardiac surgery is safe and simple. This method significantly reduces the need for bank blood transfusions and offers financial savings.
Area of Science:
- Cardiovascular Surgery
- Transfusion Medicine
- Anesthesiology
Background:
- Cardiac surgery patients often require blood transfusions.
- Bank blood transfusions carry risks and incur costs.
- Alternative methods for blood management are being explored.
Purpose of the Study:
- To evaluate the safety and efficacy of autotransfusion of shed mediastinal blood in cardiac surgery patients.
- To compare bank blood requirements between autotransfusion and conventional transfusion groups.
- To assess the economic impact of autotransfusion in this patient population.
Main Methods:
- A randomized prospective study comparing autologous mediastinal blood autotransfusion (ATS) with bank blood transfusion (control).
- 63 patients in the ATS group and 51 in the control group.
- Postoperative bleeding, blood replacement, and coagulation parameters were analyzed.
Main Results:
- No significant difference in age, sex, operations, or total postoperative bleeding between groups.
- Mean postoperative blood replacement was similar, but ATS group required 50% less bank blood (p < 0.005).
- Autotransfused blood, though defibrinogenated, retained more platelets and clotting factors than bank blood.
Conclusions:
- Autotransfusion of shed mediastinal blood is a safe and simple procedure following cardiac surgery.
- This technique significantly reduces the reliance on stored bank blood.
- The method leads to considerable financial savings for patients and healthcare institutions.
Abstract:
In a randomized prospective study of patients having cardiac surgery, autologous blood collected from mediastinal tubes was autotransfused preferentially in 63 patients (ATS), whereas 51 patients received bank blood for transfusion (control). Comparison of the two groups showed no significant difference in regard to age, sex, operations performed, or total postoperative bleeding (ATS 813 +/- 121 ml. per square meter versus control 711 +/- 93 ml. per square meter; N.S.) Although mean postoperative blood replacement was similar in the two groups (ATS 4.3 +/- 0.6 units per patient versus control 4.8 +/- 0.6 units per patient), requirements for transfusion of stored bank blood were reduced by 50 percent in the ATS group (ATS 2.4 +/- 0.3 units per patient versus control 4.8 +/- 0.6 units per patient; p less than 0.005). Coagulation studies demonstrated that this blood was defibrinogenated; yet it contains significantly more platelets and clotting factors than does bank blood. In this study, autotransfusion of shed mediastinal blood was safe and simple. It significantly reduced bank blood requirements and resulted in substantial financial savings for the patients and the hospital.