ACUTE NORMOVOLEMIC RED-CELL EXCHANGE FOR CARDIOPULMONARY BYPASS IN SICKLE-CELL DISEASE

A patient with sickle cell disease (hematocrit, 28.5%; hemoglobin S fr action, 79%), required mitral valve repair. Partial red cell removal a nd blood component sequestration with an autotransfusion device before cardiopulmonary bypass initially decreased the sickle red cell mass. This was followed by an acute one-volume whole blood exchange transfus ion performed upon the initiation of cardiopulmonary bypass, resulting in a further reduction. Both techniques yielded fresh autologous plas ma for use; sequestration yielded a platelet-pheresis product. Adequat e postbypass hemostasis was demonstrated. (C) 1998 by The Society of T horacic Surgeons.