[Systematic peroperative use of an autotransfusion system in heart surgery. A prospective and comparative study in 283 patients].
A series of 283 patients undergoing cardiac bypass surgery was studied to determine whether intraoperative autotransfusion, haemodilution, and a change in transfusion techniques of the same surgical team could reduce homologous blood requirements. The Cell-Save Haemonetics* system was used systematically in 167 consecutive patients (Group I). This group of autotransfused patients was analysed prospectively and compared with a control group (Group II) of 116 patients operated one year before and analysed retrospectively. During the whole hospitalisation, homologous blood products were required in 40.7% of patients in Group I compared with 73.3% of patients in Group II (p less than 0.0001). The average requirements of packed cells per patient were 2.7 +/- 1.3 in Group I compared with 4.1 +/- 2.5 in Group II (p less than 0.0001). The haematocrit on discharge from the department was 29.9 +/- 4% in Group I compared with 32 +/- 4.5% in Group II (p less than 0.0001). The average volume of blood recovered by the system and then autotransfused was 620.8 +/- 242.6 ml. There was no significant difference in postoperative bleeding in the first 24 hours between the two groups. This study confirms that peroperative autotransfusion during cardiac surgery and the acceptance of a clinically well tolerated normovolumic anaemia are associated with a significant reduction in homologous blood consumption.
Nataf
P
P
Service de chirurgie thoracique et cardio-vasculaire, hôpital de la Pitié, Paris.
Jault
F
F
Vaissier
E
E
Levasseur
J P
JP
Pétrie
J
J
Simoneau
F
F
Fontanel
M
M
Léger
P
P
Fournel
J J
JJ
Cabrol
C
C
D000328:Adult; D000368:Aged; D001804:Blood Transfusion, Autologous / Q000295:instrumentation / Q000379:methods; D006348:Cardiac Surgical Procedures; D005112:Extracorporeal Circulation; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies
D006454:Hemoglobins
Utilisation peropératoire systématique d'un système d'autotransfusion en chirurgie cardiaque. Etude prospective et comparative sur 283 malades.