Blood products with autologous transfusion versus allogeneic transfusion in cardiac surgery patients
DOI:
https://doi.org/10.24875/RMIMSS.M20000066Keywords:
Blood Donors, Hemodilution, Blood Transfusion, Cardiac Surgical ProceduresAbstract
Background: Given the high frequency of allogeneic transfusion in cardiac surgery procedures, which expose the patient to the risks associated with transfusion, autologous transfusion arises as an alternative.
Objective: Compare the use of autologous transfusion versus allogeneic transfusion in patients undergoing cardiac surgery with cardiopulmonary bypass.
Material and methods: A prospective analytical cohort study of 26 patients undergoing cardiac surgery with cardiopulmonary bypass was carried out. They were divided into two groups: the study group (n = 13) in which autologous transfusion was performed and in the control group (n = 13) only allogenic transfusion was performed. The amount of allogeneic hemocomponents transfused was compared.
Results: In the autologous transfusion group, erythrocyte concentrates were obtained on average 520.83 ml, fresh frozen plasma 416.67 ml, erythrocyte concentrates by normovolemic hemodilution 334.38 ml, platelet aferesis of 31.38 ml, cell saver of 800.12 ml, on average, transfused. From the autologous group: erythrocyte concentrates 1329.23 ml, fresh frozen plasma 303.38, platelets of 29.46 ml. The autologous transfusion group did not require allogeneic transfusion. In the allogeneic transfusion group transfused 807.89 ml of erythrocyte concentrates, fresh frozen plasma of 676.92 and platelet concentrates of 500 ml.
Conclusions: The use of autologous transfusion prevents the transfusion of allogeneic products in cardiac surgical procedures.
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References
Rojo J, Arroyo A, Estrada J. Práctica transfusional en México. Consumos, proyecciones y acciones de mejora. En:Martínez J, D'Artote AL, editores. México, D.F.:AMMTAC;2012. 47-55.
Brecher ME, Goodnough LT. The rise and fall of preoperative autologous blood donation. Transfusion. 2001;41(12):1459-62.
Society of Thoracic Surgeons Blood Conservation Guideline Task Force;Ferraris VA, Ferraris SP, Saha SP, Hessel EA, Haan CK, Royston BD, et al. Perioperative blood transfusion and blood conservation in cardiac surgery:the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists clinical practice guidelines. Ann Thorac Surg. 2007;83:S27-86.
Murphy GJ, Angelini GD. Indications for blood transfusion in cardiac surgery. Ann Thorac Surg. 2006;82:2323-34.
Goodnough LT, Despotis GJ. Transfusion medicine:support of patients undergoing cardiac surgery. Am J Cardiovasc Drugs. 2001;1:337-51.
Murphy GJ, Reeves BC, Rogers CA, Rizvi SIA, Culliford L, Angelini GD. Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery. Circulation. 2007;116:2544-52.
Hebert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med. 1999;340:409-17.
Banbury MK, Brizzio ME, Rajeswaran J, Lytle BW, Blackstone EH. Transfusion increases the risk of postoperative infection after cardiovascular surgery. J Am Coll Surg. 2006;202:131–8.
Mahoori A, Heshmati F, Noroozinia H, Mehdizadeh H, Salehi S, Rohani M. Intraoperative minimal acute normovolemic hemodilution in patients undergoing coronary artery bypass surgery. Middle East J Anesthesiol. 2009;20:423-9.
Koch CG, Liang L, Duncan AI, Mihaljevic T, Cosgrove DM, Loop FD, et al. Morbidity and mortality risk associated with red blood cell and blood-component transfusion in isolated coronary artery bypass grafting. Crit Care Med. 2006;34:1608-16.
Carson JL, Carless PA, Hebert PC. Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion. Cochrane Database Syst Rev. 2012;(4):20-42.
Grahan ID, Fergunson D, Dokainish H, Biggs J, McAuley L, Lapaucis A. Autologous versus allogeneic transfusion:patients'perceptions and experiences. CMAJ. 1999;160(7):989-95.
Norma Oficial Mexicana NOM-253-SSA1-2012, para la disposición de sangre humana y sus componentes con fines terapéuticos. México:Centro Nacional de la Transfusión Sanguínea;2012. Disponible en:https://www.gob.mx/cnts/documentos/norma-oficial-mexicana-nom-253-ssa1-2012-para-la-disposicion-de-sangre-humana-y-sus-componentes-con-fines-terapeuticos.
van Woerkens EC, Trouwborst A, van Lanschot JJ. Profound hemodilution:what is the critical level of hemodilution at which oxygen delivery-dependent oxygen consumption starts in an anesthetized human. Anesth Analg. 1992;75:818-21.
Coplay LA, Richards BS, Safavi FZ, Newton PO. Hemodilution as a method to reduce transfusion requirements in adolescents'spine fusion surgery spine. 1999;24(3):219-22.
Virmani S, Temple DK, Bhuvan C, Amandeep S, Vishnu D, Garg M, et al. Acute normovolemic hemodilution is beneficial in patients undergoing primary elective valve surgery. Ann Card Anaesth. 2010;13(1):34-8.
Gross JB. Estimating allowable blood loss:corrected for dilution. Anesthesiology. 1983;58(3):277-80.
Lawrence J. Reexploration for hemorrhage following coronary artery bypass grafting:incidence and risk factors. Arch Surg. 2008;133(4):442-7.
Careaga-Reyna G, Ramírez-Castañeda A, Sánchez-Ramírez O, Jiménez-Valdivia M, Arellano-Villavicencio A, Argüero-Sánchez R. Sistema recuperador celular en cirugía cardiaca con derivación cardiopulmonar para disminuir el uso de sangre homóloga. Cir Cir. 2001;69(6):291-4.
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