Shed mediastinal blood in 500 elective cardiac surgery patients: is there enough for retransfusion routinely?
OBJECTIVE
Since an increased use of several blood salvaging measures has contributed to a reduction in perioperative blood loss and the requirement for banked blood in recent years, the aim of this study was to establish current postoperative drainage losses in order to evaluate whether homologous retransfusion may be a useful measure to reduce autologous transfusion in elective cardiac surgery.


METHODS
This prospective clinical investigation was performed at a University Intensive Care Unit during the first six hours following cardiac surgery.


METHODS
373 men and 127 women undergoing elective cardiac surgery were investigated.


METHODS
The amount of shed blood was measured four and six hours postoperatively.


RESULTS
The average blood loss was higher in men than in women both in all operations as a whole (men, four hours: 223+/-73 ml, six hours 270+/-95 ml; women, four hours: 156+/-25 ml, six hours 195+/-22 ml), in valve replacement (men, four hours: 299+/-87 ml, six hours 350+/-101 ml; women, four hours: 187+/-30 ml, six hours: 219+/-31 ml) and in coronary artery bypass grafting (men, four hours: 197+/-69 ml, six hours: 242+/-83 ml; women, four hours: 128+/-15 ml, six hours: 173+/-18 ml). A blood loss of 400 ml was exceeded in 13% of men after valve replacement four and six hours postoperatively. In all other groups, less than 8% of patients had a loss of more than 400 ml both after four and after six hours.


CONCLUSIONS
Postoperative drainage losses in elective cardiac surgery patients are small and a measurable advantage from retransfusion seems to be unlikely. We therefore endorse the routine use of shed mediastinal blood retransfusion in these patients.
Schirmer
U
U
Department of Anesthesiology, University of Ulm, Germany.
Hemmer
W
W
Lindner
K H
KH
Goertz
A
A
Schütz
W
W
Georgieff
M
M
D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous; D001026:Coronary Artery Bypass; D017558:Elective Surgical Procedures; D005260:Female; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D008297:Male; D008482:Mediastinum; D011446:Prospective Studies