title: Transfusion of shed mediastinal blood reduces the use of allogenic blood transfusion without increasing complications.
abstract: BACKGROUND
  Reduced use of allogenic blood components is a key issue in cardiac surgery. Several methods to conserve blood have been used; reinfusion of shed mediastinal blood (RSMB) has found widespread acceptance, but the efficacy and safety are still debated. The purpose of this study was to evaluate the effects of RSMB on the use of allogenic blood components and selected complications.
  
  
  METHODS
  Six hundred and twenty-three consecutive cardiac surgery patients in three successive periods, of whom patients in the middle period did not receive RSMB due to manufacturer delivery problems, were evaluated. Patients and procedures were characterized by EuroSCORE. Prospective collected data were: units of transfused allogenic blood, fresh frozen plasma (FFP) and platelets, postoperative blood loss and postoperative complications such as dialysis, re-operation due to bleeding, sternal infection and stroke. Length of stay in ICU was used as a general indicator of perioperative complications.
  
  
  RESULTS
  The number of patients receiving allogenic blood in periods with RSMB was significantly lower (36.5% versus 54.9%, p<0.005), while no difference was seen in FFP and platelets. The average number of transfused blood units was lower in patients receiving RSMB (2.07 versus 3.41, p=0.029), while FFP (1.34 versus 2.01, p=0.11) and platelets (0.58 versus 0.95, p=0.05) were not statistically significantly different. Postoperative bleeding was lower (759 versus 967 ml, p=0.032) in the periods with RSMB.
  
  
  CONCLUSIONS
  Patients receiving RSMB were less transfused with allogenic blood and had less postoperative drainage, while the frequency of observed postoperative complications was not different from patients who did not receive RSMB.
authors.affiliation: Department of Anaesthesia and Intensive Care, Aarhus University Hospital, Skejby, Denmark. Larsfolk@rm.dk
authors.forename: Lars
authors.initials: L
authors.lastname: Folkersen
authors.forename: Mariann
authors.initials: M
authors.lastname: Tang
authors.forename: Niels
authors.initials: N
authors.lastname: Grunnet
authors.forename: Carl-Johan
authors.initials: CJ
authors.lastname: Jakobsen
mesh_terms: D000368:Aged; D016913:Blood Component Transfusion / Q000379:methods; D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000379:methods*; D001804:Blood Transfusion, Autologous / Q000379:methods*; D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008482:Mediastinum / Q000098:blood supply; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D019106:Postoperative Hemorrhage; D011184:Postoperative Period; D011446:Prospective Studies