Acute Blood Utilization in Adult Open Heart Surgery
ABSTRACT Background: Cardiopulmonary bypass affects the homeostatic system of the body through the effect of heparinization, hemodilution and hypothermia, which represent the major challenges on the homeostatic system .Other factors, like pre-operative aspirin use, old age and cardiopulmonary bypass time, also affect the homeostatic system.
Objectives: To find factors which are related to excessive blood loss following open-heart surgery and to study pre-operative and post-operative blood transfusion practice in these patients. The importance of fresh blood transfusion, especially autologous blood, in openheart surgery was also studied.
Methods: Forty-eight adult patients, who underwent open-heart surgery over the period of 3 months, were studied. Data were collected from the charts of these patients to study their effects on the degree of post-operative blood loss.
Results: Thirteen patients (27%) had excessive blood loss (more than 1000 ml within the first 24 hours post-operatively). The incidence of excessive blood loss was related to the number of units of fresh blood which were given to the patients post- operatively. It was found to be related to patient's age, cardiopulmonary bypass time, also type of surgery and preoperative aspirin use. Two complications of blood transfusion post-operative were noted; allergic and pyrogenic reactions.
Conclusions: Fresh blood transfusion showed great effect in reducing post-operative blood loss. Factors that may increase the possibility of excessive bleeding are pre-operative aspirin use, age more than 40, prolonged cardiopulmonary bypass time and surgery for double valve replacement.
Keywords: Blood utilization, Open heart surgery, Postoperative bleeding, Fresh blood transfusion. Iraqi Medical Journal Vol. 65, No. 2, July 2019; p.107-112.
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