CURRENT METHODS TO REDUCE THE ADVERSE HEMATOLOGICAL CONSEQUENCES OF CARDIOPULMONARY BYPASS

Bleeding remains a significant cause of morbidity after cardiac surger y and results in a major demand on blood transfusion capacity. The aet iology is multifactorial, but platelet dysfunction is the most importa nt cause. Because of the potential risks of heterologous blood transfu sion, a number of techniques have been developed to reduce its need. T hese can broadly be divided into three categories. First, modification of bypass methods and the use of agents such as aprotinin can reduce blood loss. Second, more use can be made of the patient's own blood th rough predonation of autologous blood or blood conservation techniques . Finally, transfusion policy can be modified so that a lower postoper ative haemoglobin level is accepted. However, a method with which to p reoperatively predict those patients who will bleed significantly rema ins elusive.