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Ann Thorac Surg 1990;50:843-851
© 1990 The Society of Thoracic Surgeons
Division of Cardiothoracic Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
* Address reprint requests to Dr Scott, Division of Thoracic Surgery, Department of Surgery, University of New Mexico Medical Center, 2211 Lomas Blvd NE, Albuquerque, NM 87131.
We reviewed current blood conservation techniques and their use in cardiac surgery. Avoidance of aspirin preoperatively is an important blood conservation measure. Patients scheduled lor an elective operation should participate in autologous predonation programs. With careful monitoring, patients with major coronary artery disease can safely donate blood preoperatively. Intraoperative processing of blood withdrawn before cardiopulmonary bypass provides autologous platelet-rich plasma for infusion after reversal of heparin sodium. Blood collected from the field during operation and blood remaining in the oxygenator after bypass can also be processed to yield washed and concentrated red blood cells for reinfusion. Randomized, prospective studies document that postoperative autotransfusion is both safe and effective in reducing homologous blood use. Aprotinin reduces plasma protein activation and platelet damage during bypass. The integration of available blood conservation techniques into a comprehensive program combined with careful consideration of the indications for transfusion may allow more patients to avoid transfusion entirely.
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