Blood usage in open heart Surgery

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The rapid growth of open heart surgery has placed great demands on blood banks throughout the world. Several years ago, many of the leading cardiac centers in the United States were surveyed and it was found that cardiopulmonary procedures had more than doubled and an average of eight units of homologous blood had been used per patient. If this continues, a nation’s entire blood resource could be consumed by cardiac surgery. The incidence of transfusion reaction, hepatitis, coagulation abnormalities, and hemolysis increases when more blood is given to the patient. Reducing the amount of blood used during open heart operations appears to be the most likely solution to this problem.

All known blood-conserving methods preoperatively, operatively, and postoperatively were employed in a group of 249 patients undergoing cardiac surgery. These include autotransfusion, total hemodilution, careful hemostasis, the use of postoperative volume expanders other than blood, and the treatment of anemia. With he-modilution it is not necessary to add blood to prime the heart-lung machine. Autotransfusion is a process of removing 500 to 2000 cc of blood from a patient before he goes on cardiopulmonary bypass, and it is stored and returned after termination of perfusion and neutralization of heparin. Erythrocytes, platelets, and blood-clotting factors are spared the trauma from the heart-lung machine. It has been reported to decrease the amount of blood given postoperatively by 18% to 25%. Circulating volume deficits were replaced with a balanced electrolyte solution or plasmanate. Basic surgical technical factors that help to conserve blood, such . . .