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Evaluation of laboratory coagulation and lytic parameters resulting from autologous whole blood transfusion during primary aortocoronary artery bypass grafting.

Abstract：

STUDY OBJECTIVE:To determine if autologous blood reinfusion influences overall hemostatic function following aortocoronary artery bypass graft (CABG) surgery, and if so, where the predominant area of this influence lies. DESIGN:Prospective, with control values on each patient. SETTING:Cardiac operating room of a major university-affiliated county hospital. PATIENTS:20 patients undergoing elective CABG surgery. INTERVENTIONS:Following heparinization, and prior to cardiopulmonary bypass (CPB), venous blood (average 4.9 ml/kg) was removed via an indwelling internal jugular catheter into a preservative-free plastic transfer pack unit and stored without agitation at room temperature. This autologous whole blood was reinfused after systemic protamine reversal of heparin. Blood samples for analysis were drawn immediately before and 5 minutes after completion of the reinfusion. MEASUREMENTS AND MAIN RESULTS:Autologous blood reinfusion appears to be significantly related to increased hemoglobin, hematocrit, platelet count, fibrinogen, plasminogen, and antiplasmin levels. The prothrombin time and activated partial thromboplastin times decreased significantly, whereas activated clotting times and D-dimer levels were unchanged. Significant increases occurred in the following thromboelastography parameters: maximum amplitude, amplitude 60 minutes after the maximum amplitude, and whole blood clot lysis index. Reaction time and coagulation time were not statistically different from control values. CONCLUSIONS:Significant improvements in coagulation and lytic parameters occur following CPB after the infusion of autologous blood. These improvements in coagulation indices may be the result of the infused blood or hemoconcentration, which is also known to occur during this period. Additional control studies are needed to differentiate these effects.

journal_name

J Clin Anesth

journal_title

Journal of clinical anesthesia

authors

Whitten CW,Allison PM,Latson TW,Ivy R,Burkhardt D,Gulden RH,Cochran RP

doi

10.1016/0952-8180(95)00236-7

subject

Has Abstract

pub_date

1996-05-01 00:00:00

pages

229-35

issue

eissn

0952-8180

issn

1873-4529

pii

0952-8180(95)00236-7

journal_volume

pub_type

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Evaluation of laboratory coagulation and lytic parameters resulting from autologous whole blood transfusion during primary aortocoronary artery bypass grafting.