Blood saving in cardiac surgery Preliminary results

BLOOD SAVING IN CARDIAC SURGERY Preliminary

results

D. PARROT (MD), 3-p. MERLE (MD), A. REROLLE (MD), J.P. LANCON (MD) A. BERNARD (MD), J.F. ~BADIA (MD), B. CAILLARD (MD) D.A.R. INTRODUCTION : The aim of this study praise the blood economy managed by rative Blood Recovery System (IBRS) surgery. four PATIENTS AN0 METHOD : Fourty going aortocoronary bypass surgery assigned in three groups : fourteen

H6pital

du Bocage - 21034 Dijon C&Jex

was to apan Intraopein cardiac

patients

under-

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I (control

group)

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patients in Homologous Blood fifteen patients in group II and fif(HE) only, received the blood teen patients in group III content of the oxygenator after concentration by the IBRS (Haemonetics'Cell Saver III) but without any washing at the end of operation. Then, each paIII received their own mediastinal tient in group drainage blood shed during six hours after operation after concentration and washing by the MDBRS (Haemonetics'Haemolite). They all received HB if necessary in order to obtain a haematocrit of 28 to 30 % at the end of operation and 30 to 32 % the All operations were performed over following day. The groups were identical a three months period. with respect to age, sex, body surface, pre and postoperative haematocrits, graft number, bypass duration, pre and postoperative coagulation paramediastinal blood loss. meters and postoperative Patients whose preoperative haematocrit was less than 35 % and emergency patients under intraaortic balloon pump were excluded. Cannulation, bypriming and heparin management were perforpass med in the same way for the three groups. Bacteriological cultures of autologous blood were cardata were collected : ried out. The following amount of oxygenator saved blood and its haematocrit, amount of transfused homologous blood, immediate postoperative haematocrit, amount of mediastinal blood loss at the sixth hour, its haematocrit and fibrin level, amount of postoperative washed recovered blood and haematocrit the day after operation. Comparisons of quantitative variables were performed using a variance analysis, Chi 2 test were used for comparison of qualitative variables. P
group

HB unit

received

P = 0,0001 Tabl.1 : Amount of homologous transfused during operation.

packed

P = 0,025 Tabl. II : Amount of homologous packed cells units transfused after operation . Comparison between group II and III.

DISCUSSION thors (I),

: Contrary to the opinion of the present study demonstrated a statistically an IBRS allows

some authat signifi. the use of cant economy of HB, But since this method does (2), it must be combined not avoid HB requirement with other techniques. In this study, retransfudrainage losses during the sion of mediastinal first six hours after cardiac surgery caused a si. gnificant reduction in the need for transfusion of homologous blood.

REFERENCES (I) (E), que.

CHAUVAUD (S), MASSONNET-CASTEL (S), PELISSIER en chirurgie cardiaet al : Autotransfusion Inter&t du lavage globulaire dans les interventions a haut risque hemorragique - Ann Chir 41 : 421-425, 1907.

RESULTS : The amount of HB units which was transfused during the operation was statistically different between group I and group II, and between group I and group III (tabl.1). The amount of HB units which was transfused after operation was different between group I and group statistically III and between group II and group III (tabl.11) there was no difference between group I and then group II. There was neither infectious nor deleterious effect.

(2) PARROT (D), MERLE (JP), Utilisation du "Cell Saver" que sous CEC. Cah Anesthesiol

86

LANCON (JP) et al : en chirurgie cardia36 : 445-449, 1908.