The Relationship between Low Intraoperative Hematocrit Levels during Cardiopulmonary Bypass and Postoperative Neurological Events

Abstract

Objective: The objective of our study is to analyze
whether low intraoperative hematocrit levels have an effect
upon postoperative neurological events.
Methods: Our study included 140 patients who underwent
isolated coronary bypass under cardiopulmonary bypass
between 2009 and 2012. The main group of the study was
70 patients with intraoperative hematocrit levels lower than
22%. These patients’ 30-day postoperative neurological (particularly
stroke) follow up was registered as the main data of
the study. Another group of 70 patients possessing the same
demographic features who underwent open heart surgery
with hematocrit levels remaining above 22% were registered
as the control group for perioperative neurological data.
Results: The average age of the patients with hematocrit
levels below and above 22% was 56.8 ± 5.8 years and 54.1
± 7.3 years, respectively. The mean follow-up period of the
patients was 37.2 ± 8.6 days. None of the patients had any
neurological postoperative sequalae. No mortalities occurred.
One patient who had mild paresthesia and motor weakness
of the left hand had no pathological finding on computed
tomography and was diagnosed with peripheral neuropathy
due to intraoperative sternal retraction.
Conclusion: Because our study revealed no cerebrovascular
events, coronary bypass surgery under cardiopulmonary
bypass may be safely conducted even in patients with hematocrit
levels lower than 22%.