THE EFFECTS OF INTRAOPERATIVE AUTOLOGOUS WHOLE-BLOOD SEQUESTRATION ONTHE NEED FOR TRANSFUSION OF ALLOGENIC BLOOD AND BLOOD PRODUCTS IN CORONARY-BYPASS OPERATIONS

We investigated the effect of intraoperative autologous blood sequestr ation (IABS), an old blood conservation method, on trasfusion requirem ents for homologous packed red blood cells (PRBC), platelets, and fres h frozen plasma (FFP) for patients undergoing coronary bypass surgery, This non-randomized retrospective study involved 204 patients who und erwent isolated primary coronary artery bypass grafting (CABG), In 140 patients (IABS Group), autologous heparinized whole blood was removed intraoperatively via aortic cannula before bypass and retransfused at the conclusion of extracorporeal circulation, In 64 control patients, no IABS was performed, Demographic characteristics and operative and perioperative variables for both groups were similar (p>0.05). In 140 patients, the mean sequestered blood volume was 1430 ml (range=700-210 0 mi), The banked PRBC requirement during hospitalization was 1.91 uni ts in the No IABS Group and 2.25 units for the IABS Group (p=0.2957). The need for platelet transfusion was 3.06 units in the No IABS Group and 1.09 units in the IABS Group (p=0.0003), In the No IABS Group, 1.3 1 units of FFP was transfused and Ln the IABS Group, 0.49 units was tr ansfused (p=0.0004), To identify possible confounding factors, we perf ormed a multivariate Poisson regression analysis for the 22 patient va riables by a forward stepwise procedure. Regression analysis indicated that IABS did not alter the need for PRBC transfusion (p=0.6194) but adjusted differences did confirm that IABS was associated with decreas ed need for transfusion of platelets and FFP (p=0.0001 and p=0.0002, r espectively), We conclude that IABS is a safe, simple, inexpensive, an d nonpharmacological blood conservation technique, and its use in pati ents undergoing primary CABG is associated with reduced need for trans fusions of platelets and FFP.