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The Journal of Thoracic and Cardiovascular Surgery, Vol 97, 213-219, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
W Dietrich, A Barankay, G Dilthey, HP Mitto and JA Richter
The efficacy of four different blood conservation techniques in decreasing
the homologous blood requirement in cardiac operations was studied
prospectively in 100 patients undergoing myocardial revascularization. The
patients were randomly assigned to four groups of 25 each as follows: group
I, retransfusion of oxygenator blood after termination of extracorporeal
circulation; group II, processing of oxygenator content by means of a cell
separator; group III, predonation of autologous blood and isovolumetric
substitution of hydroxyethyl starch (10 ml/kg bodyweight) after the
induction of anesthesia in addition to the use of a cell separator; and
group IV, predonation and the use of a cell separator plus postoperative
retransfusion of shed mediastinal blood. To form homologous groups, we
accepted only male patients without impairment of left ventricular function
for the study. In addition, patients with internal mammary artery grafts
and a duration of extracorporeal circulation less than 45 minutes or more
than 90 minutes were excluded. The bank blood requirement during
hospitalization was 2132 +/- 824 ml in group I, 1371 +/- 928 ml in group
II, 833 +/- 599 ml in group III, and 408 +/- 559 ml in group IV. The use of
blood conservation techniques resulted in reductions of homologous blood
requirements of 34%, 60%, and 80%, respectively, in groups II to IV as
compared with the requirement in group I. There were no complications
related to autologous blood transfusion. We conclude that the use of blood
conservation techniques can considerably reduce the homologous blood
requirement in cardiac operations and therefore decrease
transfusion-related risks.
ARTICLES
Reduction of blood utilization during myocardial revascularization
Institute for Anesthesiology, German Heart Center Munich, Federal Republic of Germany.
This article has been cited by other articles:
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 The Society of Thoracic Surgeons Blood Conservatio, V. A. Ferraris, S. P. Ferraris, S. P. Saha, E. A. Hessel II, C. K. Haan, B. D. Royston, C. R. Bridges, R. S.D. Higgins, G. Despotis, et al. Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery: The Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists Clinical Practice Guideline Ann. Thorac. Surg., May 1, 2007; 83(5_Supplement): S27 - S86. [Abstract] [Full Text] [PDF]
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L. Y. Lee, W. J. DeBois, K. H. Krieger, and O. W. Isom Transfusion Therapy and Blood Conservation Card. Surg. Adult, January 1, 2003; 2(2003): 389 - 400. [Full Text]
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 H. I. Flom-Halvorsen, E. Ovrum, G. Tangen, F. Brosstad, M.-A. L. Ringdal, and R. Oystese AUTOTRANSFUSION IN CORONARY ARTERY BYPASS GRAFTING: DISPARITY IN LABORATORY TESTS AND CLINICAL PERFORMANCE J. Thorac. Cardiovasc. Surg., October 1, 1999; 118(4): 610 - 617. [Abstract] [Full Text] [PDF]
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L. Sandrelli, A. Pardini, R. Lorusso, M. L. Sala, M. Licenziati, and O. Alfieri Impact of Autologous Blood Predonation on a Comprehensive Blood Conservation Program Ann. Thorac. Surg., March 1, 1995; 59(3): 730 - 735. [Abstract] [Full Text]
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 E. Smith and Z. Rayter Postoperative autotransfusion of mediastinal blood: a review Perfusion, January 1, 1990; 5(1_suppl): 25 - 30. [PDF]
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