NYMC Faculty Publications

Document Type

Article

Publication Date

10-1-2017

Department

Surgery

Abstract

BACKGROUND: Despite the recent introduction of a number of technical and pharmacologic blood conservation measures, bleeding and allogeneic transfusion remain persistent problems in open-heart surgical procedures. Efforts should be made to decrease or completely avoid transfusions to avoid these negative reactions. METHODS: Our coronary artery bypass grafting database was reviewed retrospectively and a total of 243 patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) were studied in a 12-month period (January-December 2016) after the implementation of the new program, and compared with 275 patients of the previous 12-month period.All the staff involved in the care of the patients were educated about the risks and benefits of blood transfusions and the new transfusion guidelines in a 45-min training. We revised our guidelines for transfusions based on the STS. A transfusion log was created. Reduction in IV fluid volume was targeted. CPB circuitry was redesigned to achieve significantly less prime volume. Results: The proportion of patients transfused with red blood cells was 56% (n =154) in the control group and reduced by 26.8% in the study group (29.2%; 71 patients; P < .01). Blood transfusion rate (1.7 +./- 1/3.05 +./- 1 units), postoperative hemorrhage (545 +./- 50/ 775 +./- 55 mL), respiratory support duration (12.4 +./- 7/16.8 +./- 8 h) and ICU stay (2.2+./-1.1/ 3.5+./-1.2 days) were significantly better in the blood conservation group. Conclusion: These findings, in addition to risks and side effects of blood transfusion and the rising cost of safer blood products, justify blood conservation in adult cardiac operations.

Publisher's Statement

Originally published in The Heart Surgery Forum 20 (5), E195-E198. https://doi.org/10.1532/hsf.1792

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