{"id":172,"date":"2006-08-01T00:00:01","date_gmt":"2006-08-01T00:00:01","guid":{"rendered":"https:\/\/awge.doctime.es\/?p=172"},"modified":"2016-05-24T08:24:11","modified_gmt":"2016-05-24T06:24:11","slug":"awge-240","status":"publish","type":"post","link":"https:\/\/awge.doctime.es\/index.php\/2006\/08\/01\/awge-240\/","title":{"rendered":"Effects of cell saver autologous blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing cardiac surgery on- versus off-cardiopulmonary bypass: a randomised trial."},"content":{"rendered":"

Eur J Cardiothorac S
\nNiranjan G, Asimakopoulos G, Karagounis A, Cockerill G, Thompson M, Chandrasekaran V.
\nAcceso al enlace publicador<\/a><\/p>\n

Objective: Off-pump CABG is potentially associated with reduced intraoperative blood loss and homologous blood transfusion in comparison to on-pump CABG. In this randomised controlled study we investigated the effects of autologous cell saver blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing CABG on- versus off-CPB. Methods: Eighty patients were randomised into one of four groups: (A) on-CPB with cell saver blood transfusion (CSBT), (B) on-CPB without CSBT, (C) off-pump with CSBT and (D) off-pump without CSBT. Volume of intraoperative autologous blood transfusion, postoperative mediastinal blood loss and homologous blood transfusion requirements were measured. Homologous blood was transfused when haemoglobin concentration fell below 8g\/dl postoperatively. Pre- and postoperatively prothrombin time and partial thromboplastin time were measured. Results: Preoperative patient characteristics were well matched among the four groups. The amount of salvaged mediastinal blood available for autologous transfusion was significantly higher in the on-pump group (A) compared to the off-CPB group (C) (433+\/-155ml vs 271+\/-144ml, P=0.001). Volume of homologous blood transfusion was significantly higher in group B vs groups A, C and D (595+\/-438ml vs 179+\/-214, 141+\/-183 and 230+\/-240ml, respectively, P<0.005). The cell saver groups (A and C) received significantly less homologous blood than the groups without cell saver (160+\/-197ml vs 413+\/-394ml, respectively, P<0.005). Patients undergoing off-CPB surgery received significantly less homologous blood than those undergoing on-CPB CABG irrespective of cell saver blood transfusion (184+\/-214ml vs 382+\/-397ml, P<0.05). Postoperative blood loss was similar in the four groups (842+\/-276, 1023+\/-291, 869+\/-286 and 903+\/-315ml in groups A to D, respectively, P>0.05). Clotting test results revealed no significant difference between the groups. There was no significant difference in postoperative morbidity between groups. Conclusion: Off-pump CABG is associated with significant reduction in intraoperative mediastinal blood loss and homologous transfusion requirements. Autologous transfusion of salvaged washed mediastinal blood reduced homologous transfusion significantly in the on-CPB group. Cell saver caused no significant adverse impact on coagulation parameters in on- or off-CPB CABG. Postoperative morbidity and blood loss were not affected by the use of CPB or autologous blood transfusion. We recommend the use of autologous blood transfusion in both on- and off-pump CABG surgery.<\/p>\n","protected":false},"excerpt":{"rendered":"