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Ann Thorac Surg 1993;55:410-412
© 1993 The Society of Thoracic Surgeons

Articles

Role of autogenous tissue factors in hemolysis during cardiopulmonary bypass operations

Edward G. Ford, MD*, Anthony L. Picone, MD, Clinton E. Baisden, MD

Department of Surgery, Keesler Medical Center, Keesler Air Force Base, Mississippi USA

Accepted for publication May 15, 1992.

* Address reprint requests to Dr Ford, KMC/SGHS, Keesler AFB, MS 39534.

Pericardial fluid has been implicated as a causative factor in hemolysis during cardiopulmonary bypass operations. Preoperative blood samples were obtained from 10 patients undergoing coronary artery bypass grafting for ischemic myocardial disease. Whole blood samples were separately incubated with autogenous pericardial fluid, pericardium, pleura, vein, skeletal muscle, and fat harvested during the operative intervention. The plasma fraction was separated by centrifugation and assayed for serum free hemoglobin. Statistical analysis was accomplished by the Bonferroni technique to adjust for multiple comparisons. Pericardial fluid-induced hemolysis was least (20.7 mg/dL). Pleura and muscle contributed significantly to the serum free hemoglobin level (56.3 and 112.3 mg/dL, respectively; p < 0.05). Pericardium, vein, and fat did not cause significant elevations of the serum free hemoglobin level. Postbypass hemolysis is an important management consideration that may be minimized by delicate tissue manipulation and attention to minimizing tissue trauma. Avoidance of aspiration of pericardial fluid into the autotransfusion system is not supported.




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