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Ann Thorac Surg 1983;36:173-179
© 1983 The Society of Thoracic Surgeons

Articles

The Efficacy of Postoperative Autotransfusion in Patients Undergoing Cardiac Operations

Robert G. Johnson, M.D., Karen R. Rosenkrantz, B.A., Rebecca A. Preston, R.N., Cyrus Hopkins, M.D., Willard M. Daggett, M.D.*

Surgical Cardiovascular Unit, Massachusetts General Hospital, and the Department of Surgery, Harvard Medical School, Boston, MA

Accepted for publication October 14, 1982.

* Address reprint requests to Dr. Daggett, Department of Surgery, Massachusetts General Hospital, Boston, MA 02114

The efficacy of postoperative autotransfusion in lowering the requirement for banked-blood transfusion was studied in two groups, each having 168 patients, who underwent cardiac operations between April, 1979, and May, 1980. A Sorenson autotransfusion system was available for use in the autotransfusion group, whereas the control group received routine closed mediastinal drainage. Of the autotransfusion group, 81% met the criterion for autotransfusion (mediastinal losses of 450 ml or more during 4 hours), but only 61% of the autotransfusion group actually received autologous blood (mean autotransfusion volume, 399 ± 25 ml). The patients receiving autologous blood required significantly less banked blood than their matched controls (447 ± 60 ml and 744 ± 83 ml, respectively; p < 0.001). In the subgroup of patients with large mediastinal losses (more than 1,250 ml), this difference was even greater (autotransfusion, 642 ml compared with control, 1,145 ml;p; < 0.01). Postoperative autotransfusion is a simple, safe, and cost-effective method to reduce dependence on banked blood, especially when mediastinal losses are large. Obtaining maximum benefit requires familiarity of staff with the system and use of a consistent protocol.




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