Open Cardiac Surgery without Blood and Blood Products Transplantation

Authors

  • Mehmet Kaplan Cardiovascular Surgery Clinic, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
  • Tolga Can Cardiovascular Surgery Clinic, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
  • Anil Karaagac Cardiovascular Surgery Clinic, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
  • Murat Acarel Anesthesiology and Reanimation Clinic, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
  • Adlan Olsun Cardiovascular Surgery Clinic, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
  • M. Inanc Yesilkaya Cardiovascular Surgery Clinic, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
  • Hakki Aydogan Cardiovascular Surgery Clinic, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey

DOI:

https://doi.org/10.1532/hsf.1898

Keywords:

Cardiac surgery, blood products, transfusion, transplantation, bloodless surgery

Abstract

Background: Blood transfusions are the most common type of tissue and organ transplantation. Perioperative and postoperative transfusions may cause morbidity and mortality and transfusion should based on only hematocrit values but also on hemodynamic and clinical parameters of the patient, which cannot be ignored.

Methods: A prospective study was conducted between January 2015 and October 2016 with adult patients undergoing elective open heart surgery. In these patients, a protocol was established, and patients were divided into two groups as transfusion (-) and transfusion (+). In the first 24 hours in the intensive care unit, patients’ drainage, 24-hours urine output, awakening and extubation times, and lactate and bilirubin levels in arterial blood gases were recorded. Thirty-day mortality and morbidity, and hemodynamic and clinical data were compared between these two groups.

Results: We have performed a total of 138 cases; no blood and blood products were transfused in 71% (n = 98), and in 29.0% (n = 40) blood and blood products were transfused. Thirty-day mortality and morbidity (arrhythmia, infectious and pulmonary morbidity, myocardial infarction, cerebrovascular accident, renal dysfunction, sternal revision) were compared between these two groups and no statistically significant difference was observed. Patients’ awakening, extubation time, cardiopulmonary bypass period, cross-clamp time, and days in intensive care unit and hospital were compared, and there was no statistically significant difference between the two groups. 

Conclusion: In this study, we conclude that open heart surgery without blood transfusion may be accomplished with decent peri/postoperative management. The patients who did not receive any blood or blood products were not compromised clinically or hemodynamically. No extra morbidity and mortality were seen in the non-transfusion group. Transfusion decision was based on clinical and hemodynamic parameters such as persistent hypotension or tachycardia, hyperlactatemia, low urine output, and anemic symptoms. 

Author Biography

Mehmet Kaplan, Cardiovascular Surgery Clinic, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey

Cardiovascular Surgery

References

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Published

2017-12-01

How to Cite

Kaplan, M., Can, T., Karaagac, A., Acarel, M., Olsun, A., Yesilkaya, M. I., & Aydogan, H. (2017). Open Cardiac Surgery without Blood and Blood Products Transplantation. The Heart Surgery Forum, 20(6), E239-E246. https://doi.org/10.1532/hsf.1898

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