Reduction of homologous blood transfusion in reoperative valve surgery.
From April 1979 to October 1993, 126 adult patients underwent reoperative cardiac valve surgery. Patients were divided into two groups: 53 patients who underwent surgery before January 1990 (group 1) and 73 patients who underwent surgery after January 1990 (group 2). After January 1990, a clinical strategy for reducing homologous blood transfusions was implemented, including the use of predonation of autologous blood in the operating room, reduced heparin doses, an elevated threshold of indication for blood transfusion, and autotransfusion of shed, drained blood after surgery. In group 1, 44 patients (93.0%) received an average of 3785 +/- 1251 ml of homologous blood transfusions. In group 2, only 26 patients (35.6%) needed homologous blood transfusions and had a smaller amount (2985 +/- 1521 ml) on average. Furthermore, only seven patients needed fresh blood transfusion in group 2.
Department of Cardiovascular Surgery, Tenri Hospital, Nara, Japan.
Y
Y
Okita
S
S
Miki
Y
Y
Ueda
T
T
Tabata
T
T
Sakai
K
K
Matsuyama
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D001804:Blood Transfusion, Autologous; D001810:Blood Volume; D006348:Cardiac Surgical Procedures / Q000639:trends; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006351:Heart Valves / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000379:methods; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012086:Reoperation
D006493:Heparin