INFLUENCE OF POSTOPERATIVE RETRANSFORMATI ON OF AUTOLOGOUS BLOOD PRODUCTS ON HEMOSTASIS IN CARDIAC-SURGERY

In cardiac surgery a reduction of homologous blood products is mainly achieved by autologous blood salvage. Unprocessed retransfusion of aut ologous blood may induce changes in hemostasis. We assessed changes of activated clotting times (ACT) after retransfusion of unprocessed (1) oxygenator blood and (2) shed mediastinal blood. In 41 patients under going cardiac surgery (37 revascularization and 4 valve procedures) wi th a mean cardiopulmonary bypass time of 116.3 min, ACT was measured a t the following time points: pre- and postoperatively and before and a lter retransfusion of oxygenator blood and shed mediastinal blood. A s ignificant prolongation of ACT values was and retransfusion of shed me diastinal blood showed a mean ACT of 118+/-14 vs 115+/-20 sec from bef ore to after transfusion. There was a significant correlation between the ACT value in the unprocessed oxygenator blood and the ACT value me asured in the patient after retransfusion (r = 0.41, p < 0.02). 6 pati ents receiving over 1 litre of unprocessed autologous blood (either fr om the oxygenator or the mediastinum) in less than 60 minutes showed a significant increase of ACT value after transfusion (p < 0.05). Hence , under normal conditions, retransfusion of unprocessed autologous blo od will not significantly alter hemostasis measured by the ACT test in patients undergoing cardiac surgery.