AUTOTRANSFUSION AFTER CORONARY-ARTERY BYPASS-SURGERY - IS THERE ANY BENEFIT

Postoperative salvage autotransfusion of shed mediastinal blood, using the cardiotomy reservoir, is an inexpensive technique whose efficacy and safety are evaluated in this study. We randomized 75 consecutive p atients into two groups. The autotransfusion group (n = 42) received a utotransfusion after the completion of the coronary artery bypass graf ting (CABG) until the drainage was less-than-or-equal-to 50 mL per hou r for 2 consecutive hours. The control group (n = 33) was treated with standard chest drainage. Both groups received homologous blood transf usion when the hematocrit fell below 30%. Packed red cells were requir ed post-operatively in 84.8% of the control group and 80.9% of the aut otransfusion group (p = NS). Postoperative colloid fluid replacement ( excluding autotransfusion fluid) did not differ significantly between the groups. The prothrombin time was significantly higher in the autot ransfusion group 24 hours postoperatively (p = 0.03). The fibrin degra dation products were elevated only in the serum of the autotransfusion patients (p < 0.002). More febrile patients were seen in the autotran sfusion group although not significantly more than the controls. The a utotransfusion group received more red cells than the control group, b ut it lost more red cells in the mediastinal drains. In conclusion, th e autotransfusion of shed mediastinal blood has not proved beneficial in reducing the postoperative requirements in homologous blood in pati ents undergoing coronary artery bypass grafting (CABG).