Does transfusion of residual cardiopulmonary bypass circuit blood increase postoperative bleeding? A prospective randomized study in patients undergoing on pump cardiopulmonary bypass
- PMID: 20041077
- PMCID: PMC2798762
- DOI: 10.4103/0973-6247.42659
Does transfusion of residual cardiopulmonary bypass circuit blood increase postoperative bleeding? A prospective randomized study in patients undergoing on pump cardiopulmonary bypass
Abstract
Objective: Homologous blood transfusion after open heart surgery puts a tremendous load on the blood banks. This prospective randomized study evaluates the efficacy of infusing back residual cardiopulmonary bypass (CPB) circuit i.e., pump blood as a means to reduce homologous transfusion after coronary artery bypass surgery (CABG) and whether its use increases postoperative drainage.
Materials and methods: Sixty-seven consecutive patients who underwent elective CABGs under CPB were randomized into 2 groups: (1) cases where residual pump blood was used and (2) controls where residual pump blood was not used. Patients were monitored for hourly drainage on the day of surgery and the 1(st) postoperative day and the requirements of homologous blood and its products. Data were matched regarding change in Hemoglobin, Packed Cell Volume and coagulation parameters till 1st postoperative day. All cases were followed up for three years.
Results: There was a marginal reduction in bleeding pattern in the early postoperative period in the cases compared to controls. The requirement of homologous blood and its products were also reduced in the cases.
Conclusions: The use of CPB circuit blood is safe in the immediate postoperative period. The requirement of homologous blood transfusion can come down if strict transfusion criteria are maintained.
Keywords: Cardiopulmonary bypass circuit blood; homologous blood transfusion; residual pump blood; transfusion.
Conflict of interest statement
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References
-
- Goodnough LT, Despotis GJ, Hogue CW, Jr, Ferguson TB., Jr On the need for improved transfusion indicators in cardiac surgery. Ann Thorac Surg. 1995;60:473–80. - PubMed
-
- Cosgrove DM, Thurer RL, Lytle BW. Blood conservation during myocardial revascularisation. Ann Thorac Surg. 1979;28:184–9. - PubMed
-
- Zubiate P, Kay JH, Mendez AM, Krohn BG, Hochman R, Dunne EF. Coronary artery surgery: A new technique with use of little blood, if any. J Thorac Cardiovasc Surg. 1974;68:263–7. - PubMed
-
- Gravlee GP, Hopkins MB, Yetter CR, Buss DH. Heparin content of washed red blood cells from the cardiopulmonary bypass circuit. J Cardiothorac Vasc Anesth. 1992;2:140–2. - PubMed
-
- Johnson RG, Thurer RL, Kruskall MS, Sirois C, Gervino EV, Critchlow J, et al. Comparison of two transfusion strategies after elective operations for myocardial revascularization. J Thorac Cardiovasc Surg. 1992;104:307–14. - PubMed