ASPIRIN DOES NOT INCREASE HOMOLOGOUS BLOOD REQUIREMENTS IN ELECTIVE CORONARY-BYPASS SURGERY

Studies have demonstrated increased homologous blood product requireme nts in patients on aspirin (ASA) undergoing cardiac surgery. We reexam ined the influence of ASA therapy on hemorrhage and transfusion requir ements in patients undergoing elective coronary artery bypass (CAB) su rgery in Light of recent transfusion-sparing practices and autologous cell salvaging techniques. Records from 197 patients who underwent rei nfusion of postoperatively shed mediastinal autologous whole blood wer e retrospectively reviewed, including 87 patients who received ASA wit hin 1 wk prior to surgery and 110 control patients. Patients undergoin g repeat cardiac operations were excluded from the study. Cardiopulmon ary bypass (CPB) duration, procedure length, aortic cross-clamp time, and number of grafts performed did not differ significantly between gr oups. None of the patients required reexploration for bleeding. There was significantly more mediastinal tube drainage in the ASA group (27% ), but it did not affect homologous blood component requirements becau se this blood was autotransfused. In addition, there were no significa nt differences in platelet, fresh frozen plasma, and cryoprecipitate u se between the groups. Thus, ASA did increase bleeding but did not inc rease homologous blood transfusion requirements in elective CAB surger y.