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Our experience of intraoperative autologous blood donation in patients undergoing elective valve surgery

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Background

Allogenic blood transfusions are associated with risks, costs, intermittent shortages, and questionable efficacy. Multiple alternatives have been advocated, and intraoperative autologous blood donation (IAD) or acute normovolemic hemodilution is one of these options.

Methods

Ninety-nine patients were allocated into two groups, group A (n = 50) where intraoperative blood donation was done and group B (n = 49) where standard care was provided without autologous blood donation. Autologous blood was removed and was replaced simultaneously with an equal volume of hydroxyl-ethyl starch solution in group A. Banked blood was transfused in both the groups when the hemoglobin (Hb) was less than 6g/dl on cardiopulmonary bypass (CPB) and less than 9g/dl after CPB.

Results

The two groups were comparable as regard to demographic data, type of surgical procedures, duration of CPB, duration of aortic cross clamp, duration of postoperative ventilation, re-exploration for excessive bleeding, postoperative coagulation profile, chest tube drainage, liver function, and renal function. However, the lowest Hb recorded on CPB was significantly lower in group A (6.7 ± 0.38 vs. 8.1 ± 0.62, p < 0.0001). The postoperative platelet count was higher in group A (1.95 ± 0.21 vs. 1.79 ± 0.18, p value <0.001). Total allogenic blood requirement measured in units (bags) was significantly lower in group A both intraoperatively (0.73 ± 0.52 vs. 1.7 ± 0.44, p < 0.000) and postoperatively (1.58 ± 0.6 vs. 2.3 ± 0.8, p value < 0.0001). Postoperative FFP requirement was also significantly lower in group A—340 ± 102.51 ml vs. 522.65 ± 60.71 ml, p < 0.0001. The intraoperative crystalloid requirement was significantly lower in group A—438.8 ± 116.78 ml vs. 1334.89 ± 362.56 with p value <0.0001.

Conclusion

Autologous intraoperative blood donation is a useful modality to provide better outcome after valve surgery.

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Authors and Affiliations

  1. I.P.G.M.E &R, Kolkata, India

    Kakali Ghosh, Chaitali SenDasgupta & Subhendu Mahapatra

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  1. Kakali Ghosh
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  2. Chaitali SenDasgupta
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  3. Subhendu Mahapatra
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Correspondence to Chaitali SenDasgupta.

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Ghosh, K., SenDasgupta, C. & Mahapatra, S. Our experience of intraoperative autologous blood donation in patients undergoing elective valve surgery. Indian J Thorac Cardiovasc Surg 31, 133–140 (2015). https://doi.org/10.1007/s12055-015-0359-4

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  • DOI: https://doi.org/10.1007/s12055-015-0359-4

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