Autotransfusion after coronary artery bypass grafting halves the number of patients needing blood transfusion.
BACKGROUND
Several randomized studies about autotransfusion of shed mediastinal blood in patients undergoing coronary artery bypass grafting have resulted in divergent findings concerning reduction of the need for homologous blood transfusions. Most of these studies used less strict criteria for homologous blood transfusion than applied in daily clinical practice.


METHODS
A prospective, randomized, controlled study involving 120 patients having elective, uncomplicated coronary artery bypass grafting was performed. The autotransfusion group received transfusion of shed mediastinal blood for 18 hours. Criteria for homologous blood transfusion were hemoglobin concentration less than 5.0 mmol/L in the intensive care unit and less than 5.5 mmol/L during the rest of the hospital stay.


RESULTS
Twenty-eight percent of patients in the autotransfusion group received homologous blood transfusion versus 55% in the control group (p = 0.007). Ninety-five percent of the shed mediastinal blood was transfused. In the autotransfusion group, a total of 26 units of homologous blood was used versus 78 units in the control group (p < 0.001).


CONCLUSIONS
Autotransfusion of shed mediastinal blood in patients undergoing elective, uncomplicated coronary artery bypass grafting halves the number of patients needing homologous blood and reduces the amount of homologous blood given.
Schmidt
H
H
Department of Anaesthesiology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Mortensen
P E
PE
Følsgaard
S L
SL
Jensen
E A
EA
D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001804:Blood Transfusion, Autologous / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass / Q000379:methods / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors