Lim Mi Hee, Je Hyung Gon, Ju Min Ho, Lee Ji Hye, Oh Hye Rim, Kim Ye Ri
Department of Cardiothoracic Surgery, Pusan National University Yangsan Hospital, Medical Research Institute of Pusan National University, Yangsan, Korea.
Department of Nursing, Pusan National University Yangsan Hospital, Medical Research Institute of Pusan National University, Yangsan, Korea.
Korean J Thorac Cardiovasc Surg. 2019 Dec;52(6):385-391. doi: 10.5090/kjtcs.2019.52.6.385. Epub 2019 Dec 5.
Preoperative autologous blood donation (PABD) is a conservation strategy for reducing allogenic blood transfusion (ABT) during minimally invasive cardiac surgery (MICS). We aimed to evaluate the effects of PABD on the frequency of ABT and clinical outcomes in patients undergoing MICS.
We enrolled 113 patients (47.8±13.1 years, 50 men) undergoing MICS without preoperative anemia (hemoglobin >11 g/dL) between 2014 and 2017. Of these patients, 69 (the PABD group) donated autologous blood preoperatively and were compared to the non-PABD group (n=44). We analyzed the frequency of perioperative ABT and clinical outcomes.
Baseline characteristics did not significantly differ between groups, although preoperative hemoglobin levels were lower in the PABD group. All operations were performed using a minimally invasive approach. Patients' surgical profiles were similar. There were no cases of mortality or significant differences in early postoperative outcomes. During the early postoperative period, hemoglobin levels were higher in the PABD group. No significant difference was found in the frequency of ABT.
Although the PABD group had higher postoperative hemoglobin levels, there was no clear clinical benefit in the early postoperative period, despite a great deal of effort and additional cost. Additional PABD in the setting of strict policies for blood conservation was ineffective in reducing ABT for young and relatively healthy patients who underwent MICS.
术前自体血捐献(PABD)是一种在微创心脏手术(MICS)期间减少异体输血(ABT)的保存策略。我们旨在评估PABD对接受MICS患者的ABT频率和临床结局的影响。
我们纳入了2014年至2017年间113例接受MICS且术前无贫血(血红蛋白>11 g/dL)的患者(47.8±13.1岁,50名男性)。在这些患者中,69例(PABD组)术前捐献了自体血,并与非PABD组(n = 44)进行比较。我们分析了围手术期ABT的频率和临床结局。
尽管PABD组术前血红蛋白水平较低,但两组间基线特征无显著差异。所有手术均采用微创方法进行。患者的手术情况相似。无死亡病例,术后早期结局也无显著差异。术后早期,PABD组的血红蛋白水平较高。ABT频率无显著差异。
尽管PABD组术后血红蛋白水平较高,但尽管付出了大量努力且增加了成本,术后早期仍无明显临床益处。在严格的血液保护政策下,额外的PABD对接受MICS的年轻且相对健康的患者减少ABT无效。