Cohn L H, Fosberg A M, Anderson W P, Collins J J
Chest. 1975 Sep;68(3):283-7. doi: 10.1378/chest.68.3.283.
Blood utilization in 400 consecutive adult patients undergoing a wide variety of cardiovascular operations requiring cardiopulmonary bypass was documented following institution of: 1) complete oxygenator hemodilution; 2) intraoperative phlebotomy and autologous transfusion; 3) infusion of residual oxygenator red cells; and 4) use of reconstituted frozen cells in patients whose blood type was uncommon. These techniques have resulted in an average utilization of 4.8 units of blood per adult patient. Fourteen patients required no blood at all and a total of 259 patients required less than 5 units of blood during their entire hospital course. Physiologic effects of this blood program and hemodilution were evaluated in ten patients and the results indicate that marked reduction of red cell mass by hemodilution with hypothermia and low flow perfusion is not detrimental to satisfactory whole blood oxygenation during open heart surgery.
在采用以下措施后，记录了连续400例接受各种需要体外循环的心血管手术的成年患者的用血情况：1）完全氧合器血液稀释；2）术中放血和自体输血；3）输注氧合器剩余红细胞；4）对血型罕见的患者使用重构冷冻细胞。这些技术使成年患者平均用血4.8单位。14例患者根本不需要输血，共有259例患者在整个住院期间所需输血量少于5单位。对10例患者评估了该用血方案和血液稀释的生理效应，结果表明，在低温和低流量灌注下进行血液稀释导致红细胞量显著减少，这对心脏直视手术期间全血充分氧合并无不利影响。
