[Autotransfusion in cardiosurgery procedures]

The use of autotransfusions for planned surgery is becoming quite common. The objective of the present work was to find out whether autotransfusions are safe for cardiosurgery and what is their value.

On average 2.3 transfusion units (T.U.) of blood were taken from 62 patients (52 men and 10 women, age 53.7 +/- 10 years) with a planned revascularization of the heart muscle (54x) or valvular operations (8x). During 129 blood collections a drop of systolic pressure occurred (141 +/- before and 134 +/- 21 mm Hg after blood sampling, p < 0.02). The diastolic BP and pulse rate did not change. In nine instances (7%) the authors recorded minor side-effects. After an initial drop of haemoglobin (p < 0.001) during subsequent sampling no further drop was recorded (139.4 +/- 11.8, 130.6 +/- 9.8, 129 +/- 10.5, 130.3 +/- 11.8 g/l). The iron levels, binding capacity and ferritin were within a normal range. During operation 26% of the patients, i.e. 16 (15 men and one woman) did not need a transfusion of homologous blood. The patients were younger (44.7 +/- 8.6 years) and the extracorporeal circulation was shorter (65 +/- 29 min.) than patients with transfusions of homologous blood (37 men, 9 women, 56.8 +/- 8.6 years, 91 +/- 24 min., p < 0.001).

When contraindications are respected autotransfusions before cardiosurgery are safe. In some patients they can replace homologous blood.