BLOOD-SUPPLY TO PATIENTS SUBMITTED TO CAR DIAC-SURGERY - CAN TRANSFUSIONAL HABITS BE CHANGED

OBJECTIVE: In cardiac surgery, patients might receive unnecessary bloo d transfusions, due to the lack of a uniform criteria for blood replac ement. We set out to evaluate the effect of a transfusion education pr ogram on the homologous blood requirements of subjects undergoing card iac surgery. METHODS: In June of 1993 a transfusion education program based on international criteria was designed and put into effect in th e intensive care unit. Since that date, 133 patients (group 1), on who m we attempted to evaluate the effects of the program, were included, comparing them with 150 control patients (group 2) from the previous y ear. Multiple variables were analized, in order to confirm that the fa ctors that could affect the use of blood did not differ between the tw o groups. The impact of these variables and the program on the homolog ous blood expenditures was measured with uni and multivariant analyses . RESULTS: Blood requirements of the patients during the first day of the postoperative period were 0.9 +/- 0.1 U in group 1 versus 1.8 +/- 0.1 U in group 2 (p < 0.001) and the requeriments during their entire stay in ICU were 1.8 +/- 0.1 versus 2.6 +/- 0.1 (p < 0.005), There wer e significant differences between both groups: Hemoglobin level at the admission in ICU, anoxia time, extracorporal circulation time, and bl ood losses in the first 24 hours of their stay in ICU. However, the an alysis of covariance showed that the transfusion program exerted an in dependent influence, apart from other variables, over the decrease of blood transfusions. Morbidity and mortality were similar in both group s. CONCLUSIONS: Transfusion habits can be modified, permiting a lesser consumption of homologous blood through the adoption of education pro grams adapted to the diseases in which they will be applied.