title: An innovative simple technique of blood conservation in adult patients with tetralogy of Fallot and severely raised hemoglobin.
abstract: The adult patients of tetralogy of Fallot often present with high hemoglobin levels. High hemoglobin and hematocrit on cardiopulmonary bypass (CPB) are associated with increased hemolysis, plasma free hemoglobin, renal dysfunction or failure, postoperative bleeding, exploration for bleeding, and increased requirement of allogeneic blood and blood products. Despite the presence of high hemoglobin and its association with adverse outcome, blood conservation is rarely practiced in these patients because of the fear of possible hemodynamic instability, and hypoxemic spell. We describe an innovative, simple technique of blood conservation for adult patients of tetralogy of Fallot with severely raised hemoglobin. With this technique, hemoglobin can be normalized on CPB; moreover, there is no fear of hypoxemic spell or hemodynamic instability. Furthermore, the blood conserved is readily available for transfusion in the perioperative period, if needed.
authors.affiliation: Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India. neema@sctimst.ac.in
authors.forename: Praveen Kumar
authors.initials: PK
authors.lastname: Neema
authors.forename: Sethuraman
authors.initials: S
authors.lastname: Manikandan
authors.forename: Ramesh Chandra
authors.initials: RC
authors.lastname: Rathod
mesh_terms: D000328:Adult; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D001793:Blood Preservation; D001804:Blood Transfusion, Autologous; D002315:Cardiopulmonary Bypass / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006454:Hemoglobins; D006456:Hemoglobinuria / Q000503:physiopathology*; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D010106:Oxygenators; D013771:Tetralogy of Fallot
chemical_list: D006454:Hemoglobins