title: Hemotherapy in open heart surgery.
abstract: The clinical charts and transfusion records of 216 patients who underwent open heart surgery with cardiopulmonary bypass between August 1983 and July 1684 were reviewed. The patients were categorized into five groups according to their operative procedures. Findings from preoperative hemostatic function tests in all groups were normal. Heparin rebound was observed in all groups, probably due to underneutralization by protamine. The results suggest that the neutralization dose of protamine per milligram of heparin should be increased to a range of between 1.5 and 1.7 mg in the post-cardiopulmonary bypass period. This should also reduce the need for fresh frozen plasma. Non-blood priming of the pump for adults and acceptance of a degree of thrombocytopenia (in the range of 60 to 80 x 10(9)/L) after cardio-pulmonary bypass will lower the blood component usage. A preoperative blood order schedule for patients with open heart surgery/cardiopulmonary bypass has been suggested.
authors.affiliation: Staff Immunohematologist, Department of Pathology and Laboratory Medicine (Current address: P.O. Box 1272, Jeddah, Saudi Arabia); Staff Cardiac Surgeon, Department of Surgery (Baylor Heart Team); Staff Hematopathologist, Department of Pathology and Laboratory Medicine; and Chairman, Department of Anaesthesiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: B
authors.initials: B
authors.lastname: El-Badawi
authors.forename: W
authors.initials: W
authors.lastname: Fateih
authors.forename: G T
authors.initials: GT
authors.lastname: Roberts
authors.forename: R S
authors.initials: RS
authors.lastname: Kwik