[Quantitative and qualitative analysis of various blood-preserving measures in heart surgery].
We assessed quantitative aspects of blood salvage retrospectively in 270 consecutive coronary bypass patients over one year. They were assigned either to group A (n = 10, Cellsaver [Haemonetics]), B (n = 189, centrifugated oxygenator blood), C (n = 107, retransfusion of shed mediastinal blood) or D (n = 74, combination of method B and C). In addition, blood quality was studied prospectively in group A (n = 5), B (n = 10) and C (n = 10) and each group compared to a control group. Results (mean values/patient) were: Blood salvage with A yielded 570 +/- 230 ml (hematocrit = 50%), B 509 +/- 156 ml (69%) and C 593 +/- 430 ml (26%). The required homologous blood products, i.e. packed cells (PC) and fresh frozen plasma (FFP) diminished significantly when combined autologous blood salvage was used (PC 6.0 +/- 3.4 vs 3.4 +/- 1.9, p less than 0.05; FFP 3.4 +/- 3.8 vs 2.6 +/- 3.0). Autologous erythrocyte function assessed by 2,3DPG was normal in all three methods (range 14.77-16.03 mumol/gHb). ATP was nearly normal in A (3.34 +/- 0.45 mumol/gHb), reduced by 20% in B (3.21 +/- 1.14 mumol/gHb) and by 30% in C (2.56 +/- 0.78 mumol/gHb) compared to the corresponding preoperative patient value. Hemolysis (free plasma hemoglobin) (was elevated in A (63 +/- 7 mg/dl), B (202 +/- 57 mg/dl) and C (211 +/- 44 mg/dl). However, no increase of free plasma hemoglobin was encountered in our patients after retransfusion of either A, B or C. No side effects were detected and bacteriology remained negative in all examined blood samples in C.(ABSTRACT TRUNCATED AT 250 WORDS)
Walpoth
B H
BH
Klinik für Thorax-, Herz- und Gefässchirurgie, Inselspital Bern.
Volken
U
U
Pfäffli
T
T
Mühlemann
W
W
Jutzi
H
H
Nydegger
U
U
Althaus
U
U
D000255:Adenosine Triphosphate / Q000097:blood; D000368:Aged; D001769:Blood / Q000382:microbiology; D001777:Blood Coagulation; D001803:Blood Transfusion / Q000379:methods*; D001804:Blood Transfusion, Autologous; D004912:Erythrocytes / Q000032:analysis; D005260:Female; D006461:Hemolysis; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D010949:Plasma; D012189:Retrospective Studies
D000255:Adenosine Triphosphate
Quantitative und qualitative Analyse verschiedener Blutsparmassnahmen in der Herzchirurgie.