[Strategies to reduce the use of blood components in cardiovascular surgery].
OBJECTIVE
The aim of this study is to evaluate the strategies adopted by our team to reduce the use of bloods components in patients undergoing cardiovascular surgical procedures.


METHODS
Between October 2005 and January 2007, 101 patients were operated. Fifty-one (50.5%) were male and 50 (49.5%) female. Patients' age ranged from 13 to 80 years (mean of 50.76 years). The strategy consisted in using antifibrinolytics and normovolemic hemodilution, and reinfusion of all the blood remaining in the CPB circuit.


RESULTS
Mean use of blood components was 1.45 UI, red blood cells; 0.75 UI, fresh frozen plasma; 0.89 UI, cryoprecipitate, and 1.43 UI, platelet. Fifty-nine patients (58.4%) had not used blood components and 12 (11.9%) patients used more than 4 UI of red blood cells. In 27 patients (26.7%) whose CPB time was higher than 120 minutes, 17 (63%) needed hemotransfusion. However, 3 (2.97%) developed coagulopathy and 2 (1.98%) needed reoperation due to bleeding. Of the three patients who developed coagulopathy, two were in the elderly subgroup.


CONCLUSIONS
In the presented series, the measures adopted succeeded in reducing the need of hemotransfusion in the postoperative period of thoracic surgery. Patients with CPB time higher than 120 minutes tended to need hemotransfusion. The association of surgery in elderly patients and CPB time over 120 minutes resulted in significantly greater use of blood components postoperatively.
Souza
Helmgton José Brito de
HJ
Santa Casa de Misericórdia-Hospital Santa Izabel Hospital Salvador, Salvador, BA, Brasil. helmgton@uol.com.br
Moitinho
Rilson Fraga
RF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016913:Blood Component Transfusion / Q000706:statistics & numerical data*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures / Q000191:economics; D001026:Coronary Artery Bypass; D005112:Extracorporeal Circulation; D005260:Female; D006331:Heart Diseases / Q000601:surgery*; D006438:Hemodilution; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011184:Postoperative Period; D011300:Preoperative Care; D012086:Reoperation; D055815:Young Adult
D006454:Hemoglobins