Reduction of Blood Usage in Open Heart Surgery

Tector, A. Joseph; Gabriel, Roger; Mateicka, William E.; Oparah, Sonny S.; Flemma, Robert J.; Lepley, Derward

doi:10.1378/chest.70.4.454

Cited by 32 publications

(7 citation statements)

References 16 publications

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“…While an average of nearly eight units of blood was used per case in 1971,15 reduction of blood transfusion to an average of 2.66 units of blood per patient was reported in 1976. 16 When reoperations are excluded, coronary artery bypass surgery may be associated with minimal bank blood requirements when effective intraoperative and postoperative blood salvaging techniques are implemented. tT'1s However, a number of problems has been attributed to intraoperative autologous blood transfusions, in particular bleeding tendencies when large volumes are processed.…”

Section: Discussionmentioning

confidence: 99%

The stratification of cardiac surgical procedures according to use of blood products: a retrospective analysis of 1480 cases

et al. 1991

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Section: Discussionmentioning

confidence: 99%

The stratification of cardiac surgical procedures according to use of blood products: a retrospective analysis of 1480 cases

et al. 1991

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“…Information was recorded on age, sex, surgeon, operative procedure, size of tumor, degree of differentiation, number of in- The goal of the analysis was to identify patients who received unnecessary blood transfusions and the reasons for transfusing blood deemed unnecessary. Since high-risk open heart patients easily tolerate postoperative hematocrit levels of 30% [13,14], transfusion of a colorectal cancer patient was considered unnecessary if it resulted in a postoperative hematocrit reading above 33%. The surgeons responsible for transfusing the patients in this study apparently agree since no patients were transfused when the recorded hematocrit level was greater than 33%.…”

Section: Methodsmentioning

confidence: 99%

Perioperative transfusions associated with colorectal cancer surgery : Clinical judgment versus the hematocrit

1986

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We prospectively studied 123 patients with colorectal cancer in order to identify determinants of perioperative blood transfusions and unnecessary transfusions. Transfusions were considered unnecessary if the preoperative hematocrit reading exceeded 36% or the discharge hematocrit level exceeded 33%. Age, sex, admission hematocrit reading, operative procedure, specimen length, duration of surgery, estimated blood loss, tumor size, tumor differentiation, nodal status, Dukes' staging, and attending surgeon were evaluated in relation to perioperative blood transfusion using stepwise logistic regression. Fifty-one (41%) of the 123 patients in the study were transfused and 35 patients (28%) received at least 1 unnecessary unit of blood. Advanced age, low admission hematocrit reading, high estimated operative blood loss, prolonged procedures, and lengthy specimens were significantly related to the administration of blood. Excessive intraoperative transfusions and the practice of administering blood in pairs of units accounted for the unnecessary transfusions. This study indicates that factors that influence clinical judgment and thereby the decision to transfuse a patient are not accurate indicators of when blood should be given. Greater use of pre-transfusion hematocrit testing, especially in the operating room and before transfusing a second unit of blood, will dramatically reduce blood usage in elective colorectal cancer surgery.

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“…Several authors mention the advantages in the reduction of the use of blood during CPB, such as the reduction in the demand from blood banks [19], the risk of diseases (hepatitis and AIDS) [20], transfusion reactions and coagulation disorders [21].…”

Section: Braz J Cardiovasc Surg 2004; 19(3): 287-294mentioning

confidence: 99%

<![CDATA[<b>Assessment of a new technique of hemoconcentration and the necessities of blood derivates for transfusion in patients submitted to heart surgery using cardiopulmonay bypass</b>]]>

Souza¹,

Braile²

2004

Braz. j. cardiovasc. surg.

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Objective: To assess a new technique of hemoconcentration and the necessity of blood component transfusion.Method: Eighty-six male (61.4%) and 54 female (38.6%) patients submitted to heart surgery under cardiopulmonary bypass were divided into two groups of 70 patients each according to conventional technique of blood preparation (Group A) and the use of the new technique of hemoconcentration (Group B).Results: The hemoconcentration technique is feasible and did not alter the intra-and postoperative complications of the patients. The amount of blood and plasma used during and after cardiopulmonary bypass was less in Group B patients. Moreover, the fluid balance after cardiopulmonary bypass in this group was better when compared to the Group A patients. Conclusions:The new technique of hemoconcentration was efficient regarding removal of fluids, allowed a better use of oxygenator residual contents and decreased the amount of blood components used during and after cardiopulmonary bypass. Descriptors: Hemofiltration, methods. Cardiac Surgical procedures. Blood transfusion, autologous, method. Extracorporeal circulation, methods. ResumoObjetivo: Avaliar uma nova técnica de hemoconcentração e a necessidade de transfusão de hemoderivados.Método: Foram estudados 140 indivíduos adultos submetidos à cirurgia cardíaca com circulação extracorpórea (CEC), sendo 86 (61,4%) do sexo masculino e 54 (38,6%) do Avaliação de nova técnica de hemoconcentração e da necessidade de transfusão de hemoderivados em pacientes submetidos à cirurgia cardíaca com circulação extracorpórea Assessment of a new technique of hemoconcentration and the necessities of blood derivates for transfusion in patients submitted to heart surgery using cardiopulmonay bypass 288 SOUZA, DD ET AL -Assessment of a new technique of hemoconcentration and the necessities of blood derivates for transfusion in patients submitted to heart surgery using cardiopulmonay bypass Braz

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Reduction of Blood Usage in Open Heart Surgery

Cited by 32 publications

References 16 publications

The stratification of cardiac surgical procedures according to use of blood products: a retrospective analysis of 1480 cases

The stratification of cardiac surgical procedures according to use of blood products: a retrospective analysis of 1480 cases

Perioperative transfusions associated with colorectal cancer surgery : Clinical judgment versus the hematocrit

<![CDATA[<b>Assessment of a new technique of hemoconcentration and the necessities of blood derivates for transfusion in patients submitted to heart surgery using cardiopulmonay bypass</b>]]>

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