[Autotransfusion with leap-frog technique in patients with coronary heart disease and planned aortocoronary venous bypass].
OBJECTIVE
The goal of the study is to test and control the quality of a special leap-frog technique which enables saving heterologous blood.


METHODS
In a randomized double-blind placebo-controlled study homologous blood was taken in 40 out of 100 patients with coronary heart disease before aortocoronary bypass operation. The leap-frog technique was used. Within 8 weeks 3-4 erythrocyte concentrates and 0.9-1.2 liters plasma were sampled. The volume (verum: HES 200/0.5 10%; placebo: 0.9% NaCl solution) substituted corresponding to the volume of blood donated. Each patient received 200 mg Fe2+/day p.o.


RESULTS
Clinically, only patients treated with HES in stage of autologous blood sampling benefited significantly. Two patients showed adverse effects. The peri- and postoperative course was comparable. In the NaCl group one of the patients received homologous erythrocyte concentrates. None of the patients died pre-, peri- or post-operatively.


CONCLUSIONS
40% of the cardiosurgical patients could be considered for autologous blood donation. Isovolemic hemodilution with HES 200/0.5 10% was a suitable and safe measure in preoperative blood sampling. Physical exercise should be performed before and after autologous blood donation. A reduced exercise tolerance suggests that autologous blood donation should be stopped.
Kiesewetter
H
H
Abteilung für Klinische Hämostaseologie und Transfusionsmedizin, Universität des Saarlandes, Homburg/Saar, BRD.
Jung
F
F
Pindur
G
G
Koscielny
J
J
Jakobs
K
K
Wenzel
E
E
D000328:Adult; D000368:Aged; D001804:Blood Transfusion, Autologous / Q000379:methods*; D001810:Blood Volume / Q000502:physiology; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000097:blood / Q000601:surgery*; D004311:Double-Blind Method; D017707:Erythrocyte Transfusion / Q000379:methods*; D005080:Exercise Test / Q000187:drug effects; D005260:Female; D006400:Hematocrit; D006438:Hemodilution / Q000379:methods*; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006452:Hemoglobinometry; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood; D012965:Sodium Chloride / Q000008:administration & dosage / Q000009:adverse effects; D014680:Veins / Q000637:transplantation
D006895:Hydroxyethyl Starch Derivatives; D012965:Sodium Chloride