Solem J O, Steen S, Tengborn L, Lindgren S, Olin C
Scand J Thorac Cardiovasc Surg. 1987;21(2):149-52. doi: 10.3109/14017438709106513.
The rate of postoperative bleeding was studied in 32 patients with aortocoronary bypass surgery and in 18 with aortic valve replacement. In 12 of the 50 patients, more than 500 ml of shed mediastinal blood could be saved within 8 postoperative hours. Aerobic and anaerobic cultures of such blood were obtained from the suction reservoir in 20 cases 2, 4 and 6 hours postoperatively. The results were negative, apart from Staphylococcus albus in one 6-hour sample. The blood, which was in some degree hemolyzed, contained acceptable amounts of red cells and albumin. Alterations of the coagulation and fibrinolytic systems indicated massive proteolysis with degradation of the proteins to an extent that precluded coagulation. This proteolysis had taken place in the mediastinum, resulting in total defibrinogenation of the blood. The authors conclude that in about one-fourth of cases in cardiac surgery, postoperatively shed blood is worth saving for red cell and volume substitution.
对32例行主动脉冠状动脉搭桥手术的患者和18例行主动脉瓣置换术的患者的术后出血率进行了研究。在这50例患者中，有12例在术后8小时内可挽救500多毫升纵隔引流血。术后2、4和6小时从20例患者的吸引储液器中获取此类血液进行需氧和厌氧培养。除了一份6小时样本中发现白色葡萄球菌外，结果均为阴性。这些血液在一定程度上发生了溶血，含有可接受量的红细胞和白蛋白。凝血和纤维蛋白溶解系统的改变表明存在大量蛋白水解，蛋白质降解到无法凝血的程度。这种蛋白水解发生在纵隔，导致血液完全去纤维蛋白原化。作者得出结论，在心脏手术中约四分之一的病例中，术后引流血值得保存用于红细胞和容量替代。
