Yoda M, Nonoyama M, Shimakura T
Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan.
Kyobu Geka. 2004 May;57(5):367-9.
Preoperative autologous blood donation reduces exposure to homologous blood transfusions in cardiac surgery. The purpose of this study was to ascertain, how much volume of predonated autologous blood needed to avoid of homologous blood transfusion in scheduled off-pump coronary artery bypass grafting (OPCAB).
Fifty patients underwent scheduled OPCAB. These patients donated 400 ml (group A, n = 30) or 800 ml (group B, n = 20) of autologous blood before operation. These patients donated at a rate of 400 ml per week. All patients were given an equal volume of saline solution at the time of autologous donation.
There were no significant differences mean age, mean body weight, mean preoperative hematocrit values, mean graft number or mean volume of intraoperative blood loss between groups A and B. There was significant difference the mean postoperative day-7 hematocrit value (33.4 +/- 1.5% vs 38.7 +/- 1.5%, p < 0.05). The rates of avoiding homologous blood transfusion were 63.3% in group A and 100% in group B (p < 0.05).
Autologous blood transfusion was effective for reducing the homologous blood requirement. We believe that 800 ml predonation is sufficient to avoid homologous blood transfusion in scheduled OPCAB, further patients with cardiovascular disease including severe coronary artery should be donated with the administration of saline.
术前自体血捐献可减少心脏手术中异体输血的暴露。本研究的目的是确定在预定的非体外循环冠状动脉旁路移植术(OPCAB)中,需要预先捐献多少自体血才能避免异体输血。
50例患者接受预定的OPCAB。这些患者在术前捐献400ml(A组,n = 30)或800ml(B组,n = 20)自体血。这些患者以每周400ml的速率进行捐献。在自体血捐献时,所有患者均给予等量的生理盐水溶液。
A组和B组之间的平均年龄、平均体重、术前平均血细胞比容值、平均移植血管数量或术中平均失血量无显著差异。术后第7天的平均血细胞比容值有显著差异(33.4±1.5%对38.7±1.5%,p<0.05)。A组避免异体输血的比例为63.3%,B组为100%(p<0.05)。
自体输血对于减少异体血需求是有效的。我们认为,800ml的预先捐献足以避免预定OPCAB中的异体输血,对于包括严重冠状动脉疾病在内的心血管疾病患者,应在给予生理盐水的情况下进行捐献。