[Combined erythropoietin and aprotinin use for blood conservation in elderly coronary bypass patients].
Age is one of the predictors of homologous blood transfusion (HBT) in cardiac surgery. To avoid HBT, we have employed pharmacological blood conservation techniques such as the administration of erythropoietin (EPO) in conjunction with autologous blood donation (ABD) and the administration of aprotinin in prime volume. The effectiveness of these methods was evaluted in elderly patients who underwent coronary artery bypass grafting (CABG). Seventy-nine elective coronary bypass patients were classified into two groups by age: group A (> or = 70 y.o., n = 29) and group B (< 70 y.o., n = 46). EPO (24,000 U) was administered once a week subcutaneously starting 3 weeks before the operation. ABDs were carried out as long as the blood hemoglobin levels were above 10.5 g/dl. A significant increase of preoperative blood hemoglobin was observed in both groups. Although the blood hemoglobin levels at the beginning of ABD were lower in group A than in group B, the mean amount of predonated blood per patients was similar in both groups. In 79.3% of group A and in 84.8% of group B, HBT was not required: furthermore, in the prodonated patients, this no-HBT rate could be increased to 84.0% of group A and to 88.1% of group B. These results suggest that CABG in elderly patients can be performed safely without HBT when pharmacological blood conservation techniques are employed.
Oshima
N
N
Department of Cardiovascular Surgery, Sekishinkai Sayama Hospital, Japan.
Kiyama
H
H
Imazeki
T
T
D000367:Age Factors; D000368:Aged; D007611:Aprotinin / Q000008:administration & dosage*; D001804:Blood Transfusion, Autologous / Q000379:methods*; D001026:Coronary Artery Bypass; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D012189:Retrospective Studies
D006454:Hemoglobins; D006490:Hemostatics; D004921:Erythropoietin; D007611:Aprotinin