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Ann Thorac Surg 1980;29:117-122
© 1980 The Society of Thoracic Surgeons

Articles

The Use of Blood and Blood Components in 1,769 Patients Undergoing Open-Heart Surgery

William L. Bayer, M.D.*, William M. Coenen, B.S.B.A., David C. Jenkins, M.D., Marjorie L. Zucker, M.D.

Community Blood Center of Greater Kansas City, Kansas City, MO

Accepted for publication June 29, 1979.

* Address reprint requests to Dr. Bayer, 4040 Main St, Kansas City, MO 64111

There has been a decrease in the use of whole blood and red cell transfusions during and after open-heart operations in the greater Kansas City area from an average of slightly more than 9 units per patient from 1969 through 1971, to just over 3 units per patient from 1975 through 1977. In 1977, 1,256 patients, or 71% of 1,769 patients, underwent coronary artery bypass exclusively and had an average transfusion utilization of 2.6 units. All other open-heart operations averaged 4.7 units per patient.

Hemodilution and the acceptance of hematocrits between 25 and 30% in open-heart operations are probably the main factors responsible for lower transfusion use per patient, while the increased proportion of patients undergoing coronary artery bypass accounts for a further decrease in the average amount of blood used per patient. It is of note that blood transfused to patients having an open-heart operation was not significantly fresher than blood for routine use, yet hemostasis was not a problem as evidenced by the small use of fresh-frozen plasma in 67 patients (3.8%) and platelet concentrates in 42 patients (2.4%).




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