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. 2022 Oct-Dec;25(4):399-407.
doi: 10.4103/aca.aca_30_21.

Intraoperative blood collection without fluid replacement for cardiac surgery - A retrospective analysis

Jennifer L Vance  1 , Lisa Irwin  1 , Elizabeth S Jewell  1 , Milo Engoren  1
Affiliations

Intraoperative blood collection without fluid replacement for cardiac surgery - A retrospective analysis

Jennifer L Vance et al. Ann Card Anaesth. 2022 Oct-Dec.

Abstract

Background: Transfusion rates in cardiac surgery are high.

Aim: To determine if intraoperative autologous blood removal without volume replacement is associated with fewer homologous blood transfusions without increasing acute kidney injury.

Setting and design: Retrospective, comparative study.

Materials and methods: Adult patients undergoing cardiac surgery, excluding those who underwent ventricular assist device surgery, heart transplants, or cardiac surgery without cardiopulmonary bypass were excluded, who had 1-3 units of intraoperative autologous blood removal were compared to patients without blood removal for determination of volume replacement, vasopressor support, acute kidney injury, and transfusions.

Results: Autologous blood removal was associated with fewer patients receiving homologous transfusions: intraoperative red cell transfusions fell from 75% (Control) to 48% (1 unit removed), 40% (2 units), and 30% (3 units), P < 0.001. Total intraoperative and postoperative homologous RBC units transfused were lower in the blood removal groups: median (interquartile range) 3 (1, 6) in Control patients and 0 (0, 2), 0 (0, 2) and 0 (0, 1) in the 1, 2, and 3 units removed groups, P < 0.001. Similarly, plasma, platelet, and cryoprecipitate transfusions decreased. After adjustment for confounders, increased amounts of autologous blood removal were associated with increased intravenous fluids, only when 2 units were removed, and trivially increased vasopressor use. However, it was not associated with acidosis or acute kidney injury.

Conclusions: Intraoperative autologous blood removal without volume replacement of 1-3 units for later autologous transfusion is associated with decreased homologous transfusions without acidosis or acute kidney injury.

Keywords: Acute kidney injury; autologous blood removal; cardiac surgery; transfusion.

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Conflict of interest statement

There are no conflicts of interest.

References

    1. Whitson BA, Huddleston SJ, Savik K, Shumway SJ. Bloodless cardiac surgery is associated with decreased morbidity and mortality. J Card Surg. 2007;22:373–8. - PubMed
    1. Mazer CD, Whitlock RP, Fergusson DA, Hall J, Belley-Cote E, Connolly K, et al. Restrictive or liberal red-cell transfusion for cardiac surgery. N Engl J Med. 2017;377:2133–44. - PubMed
    1. Engoren MC, Habib RH, Zacharias A, Schwann TA, Riordan CJ, Durham SJ. Effect of blood transfusion on long-term survival after cardiac operation. Ann Thorac Surg. 2002;74:1180–6. - PubMed
    1. Koch CG, Li L, Sessler DI, Figueroa P, Hoeltge GA, Mihaljevic T, et al. Duration of red-cell storage and complications after cardiac surgery. N Engl J Med. 2008;358:1229–39. - PubMed
    1. Wahba A, Black G, Koksch M, Rothe F, Preuner J, Schmitz G, et al. Cardiopulmonary bypass leads to preferential loss of activated platelets. A flow cytometric assay of platelet surface antigens. Eur J Cardiothorac Surg. 1996;10:768–73. - PubMed