Three Blood-Conservation Methods Benefit Patients Undergoing Coronary Artery Bypass Surgery
Recent research suggests postoperative bleeding and the need for postoperative transfusions can be significantly reduced following coronary artery by-pass through the use of three blood conservation techniques.
The findings, say cardiac surgeons, “may be secondary to less haemodilution and preservation of coagulant factors.”
Although blood transfusions have been frequently given following coronary artery by-pass surgery, they proved expensive and were associated with significant morbidity. Consequently, surgeons at the University of Miami School of Medicine in Florida, United States, designed a study to determine whether they could reduce the necessity for transfusion following this surgical procedure.
The alternative techniques were a combination of three inexpensive blood -conservation methods which compared to the traditional system of blood scavenging: vacuum-assisted venous return, retrograde autologous priming of the oxygenator and pre-by pass blood collection. All were selected because they were inexpensive and easy to use.
Participants were divided into two group of 50 patients each. In Group 1, surgeons used intraoperative autologous blood scavenging. These underwent retrospective comparison to Group 2, which used an unpaired student t test. Group 2 included 50 consecutive primary coronary artery bypass patients who received the three blood conservation techniques.
The surgeons reported that “there were no significant differences in either patient or operative characteristics and the mortality rate for the entire group was 1 percent.” However, patients in Group 2 revealed a significantly increased post -bypass haemoglobin levels, (11.7gm ± 1 vs 9.8 ± 1.5gm), and a noticeable reduction in the amount of chest tube drainage (195 ± 78cc vs 283 ± 91 cc). Furthermore transfusion was required for considerably fewer patients in Group 2, [18 percent (4/50) vs 32 percent 16/50), P.005].
Researchers conclude that patients benefit from surgeons utilizing this method. However, they suggest, further study is necessary.
