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Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.

2017, Number 2

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Cir Card Mex 2017; 2 (2)

Técnica de donación autóloga intraoperatoria en pacientes de cirugía cardiaca con derivación cardiopulmonar

Salazar-Hernández I, Barragán-Garate LR, Inzunza-Saldaña S

Language: Spanish
References: 14
Page: 57-59
PDF size: 199.00 Kb.


ABSTRACT

Objective. To compare the requirement for allogenic blood transfusion in patients undergoing intraoperative autologous donation in cardiac surgery with cardiopulmonary bypass, with patients without autologous donation.
Material and Methods. This is a comparative, prospective, longitudinal, experimental and single-center study. We included adult patients who required elective cardiac surgery with cardiopulmonary bypass at our institution, from March 2015 to September 2015. Pediatric patients, aortic aneurysms, aortic dissection, and emergency surgery were excluded.
Results. A total of 22 patients were included in this study. They were divided into Group 1 (perioperative autologous donation) including 11 patients with age range of 45.7 years; and Group 2 (without perioperative autologous donation) with 11 patients, with age range of 50.8 years. A significant difference was found in the length of stay in the intensive care unit (4.1 days vs 5.8 days, P = 0.026), and a low blood transfusion requirement (2 vs 10, 2 p = 0.000613).
Conclusions. The results obtained in this study suggest that the use of perioperative autologous blood donation in patients requiring elective cardiac surgery with cardiopulmonary bypass is useful, safe and is associated with a reduction in postoperative blood transfusion requirements. Avoiding blood transfusion contributes by reducing the risk of postoperative complications and long-term mortality.


REFERENCES

  1. Mazer CD. Blood conservation in cardiac surgery: guidelines and controversies.Transfus Apher Sci 2014;50:20-25.

  2. Riera M, Ibanez J, Molina M, et al. Red cell transfusion and long-term survival innon-complicated heart surgery. Med Intensiva 2014;38:422-429.

  3. Avgerinos DV, DeBois W, Salemi A. Blood conservation strategies in cardiac surgery:more is better. Eur J Cardiothorac Surg 2014;46:865-870.

  4. Ternstrom L, Hyllner M, Backlund E, Schersten H, Jeppsson A. A structured bloodconservation programme reduces transfusions and costs in cardiac surgery. InteractCardiovasc Thorac Surg 2014;19:788-794.

  5. Pearce FB, Kirklin JK, Holman WL, Barrett CS, Romp RL, Lau YR. Successfulcardiac transplant after Berlin Heart bridge in a single ventricle heart: use of aortopulmonaryshunt as a supplementary source of pulmonary blood flow. J ThoracCardiovasc Surg 2009;137:e40-e42.

  6. DeFoe GR, Ross CS, Olmstead EM et al. Lowest hematocrit on bypass and adverseoutcomes associated with coronary artery bypass grafting. Northern NewEngland Cardiovascular Disease Study Group. Ann Thorac Surg 2001;71:769-776.

  7. Teman N, Delavari N, Romano M, Prager R, Yang B, Haft J. Effects of autologouspriming on blood conservation after cardiac surgery. Perfusion 2014;29:333-339.

  8. Karkouti K, Djaiani G, Borger MA et al. Low hematocrit during cardiopulmonarybypass is associated with increased risk of perioperative stroke in cardiac surgery.Ann Thorac Surg 2005;80:1381-1387.

  9. Gunaydin S, Gourlay T. Novel ultrafiltration technique for blood conservation incardiac operations. Ann Thorac Surg 2013;95:2148-2151.

  10. Banbury MK, Brizzio ME, Rajeswaran J, Lytle BW, Blackstone EH. Transfusionincreases the risk of postoperative infection after cardiovascular surgery. J AmColl Surg 2006;202:131-138.

  11. Engoren MC, Habib RH, Zacharias A, Schwann TA, Riordan CJ, Durham SJ. Effectof blood transfusion on long-term survival after cardiac operation. Ann ThoracSurg 2002;74:1180-1186.

  12. Mullis B, Fisk E, Weaver D, Zhao Q, Daggy J, Di Cesare PE. Anemia versus transfusion:does blood conservation increase the risk of complications? Am J Orthop(Belle Mead NJ) 2015;44:E11-E16.

  13. Ferraris VA, Brown JR, Despotis GJ et al. 2011 update to the Society of ThoracicSurgeons and the Society of Cardiovascular Anesthesiologists blood conservationclinical practice guidelines. Ann Thorac Surg 2011;91(3):944-982.

  14. Chu MW, Losenno KL, Moore K, Berta D, Hewitt J, Ralley F. Blood conservationstrategies reduce the need for transfusions in ascending and aortic arch surgery.Perfusion 2013;28:315-321.




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