The Journal of Thoracic and Cardiovascular Surgery, Vol 75, 632-641, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Autotransfusion of shed mediastinal blood after cardiac surgery: a prospective study
HV Schaff, JM Hauer, WR Bell, TJ Gardner, JS Donahoo, VL Gott and RK Brawley
In a randomized prospective study of patients having cardiac surgery,
autologous blood collected from mediastinal tubes was autotransfused
preferentially in 63 patients (ATS), whereas 51 patients received bank
blood for transfusion (control). Comparison of the two groups showed no
significant difference in regard to age, sex, operations performed, or
total postoperative bleeding (ATS 813 +/- 121 ml. per square meter versus
control 711 +/- 93 ml. per square meter; N.S.) Although mean postoperative
blood replacement was similar in the two groups (ATS 4.3 +/- 0.6 units per
patient versus control 4.8 +/- 0.6 units per patient), requirements for
transfusion of stored bank blood were reduced by 50 percent in the ATS
group (ATS 2.4 +/- 0.3 units per patient versus control 4.8 +/- 0.6 units
per patient; p less than 0.005). Coagulation studies demonstrated that this
blood was defibrinogenated; yet it contains significantly more platelets
and clotting factors than does bank blood. In this study, autotransfusion
of shed mediastinal blood was safe and simple. It significantly reduced
bank blood requirements and resulted in substantial financial savings for
the patients and the hospital.