PubMed · 1670346
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P Rosenberg. 1990. [Autotransfusion].. https://pubmed.ncbi.nlm.nih.gov/1670346/
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OBJECTIVE: We assessed the current role of preoperative and intraoperative autologous blood donation in pediatric open-heart surgery. METHODS: Group 1 consisted of 51 patients between 5 and 10 years old who underwent preoperative autologous blood donation. Group 2 consisted of 50 age-matched patients without preoperative donation as controls. Intraoperative donation was conducted in both groups prior to cardiopulmonary bypass. We evaluated perioperative blood cell count, blood loss, and the need for homologous blood products. RESULTS: No serious complications occurred in preoperative or intraoperative donation. Total preoperative donation storage was 17.5 +/- 3.4 mL/kg. Intraoperative donation was 21.7 +/- 6.1 mL/kg in Group 1 and 12.8 +/- 4.0 mL/kg in Group 2 (p < 0.001). On admission, serum hemoglobin was lower in Group 1 (12.2 +/- 1.0 g/dL versus 13.6 +/- 1.6 g/dL, p < 0.001) but returned postoperatively to the preoperative value. It hovered at a depressed level in Group 2 (12.2 +/- 1.4 versus 10.2 +/- 1.1 g/dL, p < 0.001). The homologous blood requirement was significantly less in Group 1 than in Group 2 (0% versus 10%, p < 0.05). Postoperative platelet counts showed similar curves, and blood loss was not statistically significantly different between groups. CONCLUSION: Preoperative and intraoperative donations are safe and continue to contribute uniquely to blood conservation, providing important options in comprehensive blood conservation programs in current pediatric open-heart surgery.
BACKGROUND: The effect of reduced cardiopulmonary bypass (CPB) prime volume by retrograde autologous priming (RAP) was studied. METHODS: Twenty patients undergoing elective coronary artery bypass grafting were randomized to either standard prime (SP) volume (1,602 +/- 202 mL crystalloid prime, n = 10) or RAP (395 +/- 150 mL). RAP was performed by draining crystalloid prime from the arterial and venous lines into a recirculation bag before CPB. Cardiac index, pulmonary vascular resistance index, systemic vascular resistance index, alveolar-arterial oxygen tension difference, pulmonary shunt fraction, extravascular lung water (EVLW), plasma colloid osmotic pressure (COP), crystalloid fluid balance, body weight, and clinical parameters were evaluated perioperatively. RESULTS: Demographic data and operative parameters were equal for patients in both groups. During CPB, COP was reduced by 55% in the SP group (9.8 +/- 2.0 vs 21.4 +/- 2.1 mm Hg) and by 41% in the RAP group (12.4 +/- 1.1 vs 20.9 +/- 1.8 mm Hg) (p = 0.008, SP vs RAP group). Compared with preoperatively, EVLW was unchanged in the RAP group 2 hours post-CPB, but it was elevated by 21% in the SP group (p = 0.002, SP vs RAP group). End-CPB crystalloid fluid balance was significantly reduced in the RAP group (1,857 +/- 521 vs 2,831 +/- 637 mL). Postoperative (day 2) weight gain in the SP group (1.5 +/- 1.2 kg, p = 0.021) was absent in the RAP group (0.1 +/- 0.9, NS). Postoperative time to full mobilization was shorter in the RAP group. Postpump cardio-respiratory function did not differ among groups. CONCLUSIONS: This small-scale pilot study indicates that by reducing crystalloid fluid administration and fall of COP during CPB, RAP reduces postpump EVLW accumulation and weight gain in uncomplicated coronary artery bypass graft patients with no associated effects on cardio-respiratory function.
OBJECTIVES: Clinical outcomes following the exclusive use of autotransfusion in the management of ruptured ectopic pregnancy are reviewed. METHODS: A MEDLINE search (1966-2002) for relevant articles documenting the exclusive use of autotransfusion, and data collection and analysis was made. RESULTS: There were 21 studies, 16 from developing and five from developed countries, involving 632 cases of ruptured ectopic pregnancies. Hypovolemic shock with significant hemoperitoneum (>500 ml) was the most common complication. The procedure was performed completely manually in developing countries and with the help of a device in developed countries. The mean volume of autotransfused blood was over 1000 ml, with mean hemoglobin levels ranging from 6 to 12.5 g/dl. Mean posttransfusion hemoglobin levels were higher than pretransfusion levels. There was one death, thought to be due to pulmonary embolism, and nine major and minor complications. CONCLUSIONS: Autotransfusion is useful in the management of ruptured ectopic pregnancy.