INTRAOPERATIVE AUTOTRANSFUSION REDUCES BLOOD-LOSS AFTER CARDIOPULMONARY BYPASS

Background. A combination of several techniques is necessary to minimi ze the transfusion requirements for open heart operations. The benefit of plasmapheresis remains in doubt because of smaller and less effect ive platelets obtained with this technique. Therefore, we evaluated th e effects of whole blood intraoperative autotransfusion as part of a b lood conservation protocol. Methods. One hundred patients undergoing c oronary artery bypass graft operations were randomized to an autotrans fusion group (group A) or control group (group C). Group A patients ha d 10 mL/kg of whole blood removed before cardiopulmonary bypass; they had retransfusion at the termination of cardiopulmonary bypass and hep arin reversal. Both groups had intraoperative cell saving and autotran sfusion of shed mediastinal blood postoperatively. The indications for blood transfusion were standardized, and the physicians ordering bloo d products were blinded to the study. Results. Compared with the contr ol group, patients in the autotransfusion group had a 28% reduction of chest tube drainage at 8 hours and a 45% reduction in the total homol ogous blood units transfused. Conclusions. Autotransfusion during card iopulmonary bypass provides benefit in addition to other techniques in reducing blood loss and the need for blood products in the postoperat ive period.