Abstract
The object of the study was to retrospectively evaluate protective and risk factors for receiving donor blood products and red cell transfusions after coronary and valve surgery performed with a hollow-fiber oxygenator and with multiple blood-saving techniques. During the period of January 1991 to June 1993, 1310 patients underwent primary coronary and valve surgery using a hollow-fiber oxygenator at our institution; the mean age of this population was 61 ± 10 years; 977 patients were men (74.6%). Of these patients, 73.5% (963/1310) underwent coronary, 21.5% (281/1310) valve, and 5% (66/1310) combined surgery. Two hundred seventy-six (21.1%) needed donor blood product transfusions, while 153 (11.7%) patients underwent red cell transfusions. Significant risk factors for homologous blood product exposure after multivariate logistic regression analysis were, in order of importance: (1) postoperative blood loss (O.R. = 1.0009 per mL, p = 0.0000); (2) cardiopulmonary bypass (CPB) time (O.R. = 1.008 per min, p = 0.0001); (3) age at intervention (O.R. = 1.031 per calendar year, p = 0.0026); and (4) reoperation for bleeding (O.R. = 1.71, p = 0.0078). Protective factors were: (1) male gender (O.R. = 0.56, p = 0.0000); (2) preoperative withdrawal of autologous blood (O.R. = 0.66, p = 0.0016); and (3) a preoperative hematocrit greater than 34% (O.R. = 0.76, p = 0.005). When considering risk factors only for donor red cell exposure, multivariate regression analysis identified the following risk factors: (1) reoperations for bleeding (O.R. = 2.04, p = 0.0002); (2) postoperative blood losses (O.R. = 1.0007 per mL, p = 0.0005); (3) CPB time (O.R. = 1.0075 per min, p = 0.0008); and (4) age at intervention (O.R. = 1.03 per calendar year, p = 0.0160). Protective factors were: (1) intraoperative 'high-dose' aprotinin administration (O.R. = 0.61, p = 0.0024); and (2) preoperative donation if autologous blood (O.R. = 0.65, p = 0.0093); and (3) intraoperative withdrawal of autologous blood by phlebotomy (O.R. = 0.67, p = 0.0114). Applying multiple blood-saving techniques, coronary and valve procedures can now be performed with a low incidence of postoperative donor blood products and red cells exposures; autologous blood predonation and aprotinin administration were highly effective in reducing postoperative transfusion needs.
| Original language | English |
|---|---|
| Pages (from-to) | 227-235 |
| Number of pages | 9 |
| Journal | Journal of Cardiac Surgery |
| Volume | 10 |
| Issue number | 3 |
| Publication status | Published - 1995 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
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The effect of multiple blood conservation techniques on donor blood exposures in adult coronary and valve surgery performed with a membrane oxygenator : A multivariate analysis on 1310 patients. / Parolari, A.; Antona, C.; Rona, P.; Gerometta, P.; Huang, F.; Alamanni, F.; Arena, V.; Biglioli, P.
In: Journal of Cardiac Surgery, Vol. 10, No. 3, 1995, p. 227-235.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The effect of multiple blood conservation techniques on donor blood exposures in adult coronary and valve surgery performed with a membrane oxygenator
T2 - A multivariate analysis on 1310 patients
AU - Parolari, A.
AU - Antona, C.
AU - Rona, P.
AU - Gerometta, P.
AU - Huang, F.
AU - Alamanni, F.
AU - Arena, V.
AU - Biglioli, P.
PY - 1995
Y1 - 1995
N2 - The object of the study was to retrospectively evaluate protective and risk factors for receiving donor blood products and red cell transfusions after coronary and valve surgery performed with a hollow-fiber oxygenator and with multiple blood-saving techniques. During the period of January 1991 to June 1993, 1310 patients underwent primary coronary and valve surgery using a hollow-fiber oxygenator at our institution; the mean age of this population was 61 ± 10 years; 977 patients were men (74.6%). Of these patients, 73.5% (963/1310) underwent coronary, 21.5% (281/1310) valve, and 5% (66/1310) combined surgery. Two hundred seventy-six (21.1%) needed donor blood product transfusions, while 153 (11.7%) patients underwent red cell transfusions. Significant risk factors for homologous blood product exposure after multivariate logistic regression analysis were, in order of importance: (1) postoperative blood loss (O.R. = 1.0009 per mL, p = 0.0000); (2) cardiopulmonary bypass (CPB) time (O.R. = 1.008 per min, p = 0.0001); (3) age at intervention (O.R. = 1.031 per calendar year, p = 0.0026); and (4) reoperation for bleeding (O.R. = 1.71, p = 0.0078). Protective factors were: (1) male gender (O.R. = 0.56, p = 0.0000); (2) preoperative withdrawal of autologous blood (O.R. = 0.66, p = 0.0016); and (3) a preoperative hematocrit greater than 34% (O.R. = 0.76, p = 0.005). When considering risk factors only for donor red cell exposure, multivariate regression analysis identified the following risk factors: (1) reoperations for bleeding (O.R. = 2.04, p = 0.0002); (2) postoperative blood losses (O.R. = 1.0007 per mL, p = 0.0005); (3) CPB time (O.R. = 1.0075 per min, p = 0.0008); and (4) age at intervention (O.R. = 1.03 per calendar year, p = 0.0160). Protective factors were: (1) intraoperative 'high-dose' aprotinin administration (O.R. = 0.61, p = 0.0024); and (2) preoperative donation if autologous blood (O.R. = 0.65, p = 0.0093); and (3) intraoperative withdrawal of autologous blood by phlebotomy (O.R. = 0.67, p = 0.0114). Applying multiple blood-saving techniques, coronary and valve procedures can now be performed with a low incidence of postoperative donor blood products and red cells exposures; autologous blood predonation and aprotinin administration were highly effective in reducing postoperative transfusion needs.
AB - The object of the study was to retrospectively evaluate protective and risk factors for receiving donor blood products and red cell transfusions after coronary and valve surgery performed with a hollow-fiber oxygenator and with multiple blood-saving techniques. During the period of January 1991 to June 1993, 1310 patients underwent primary coronary and valve surgery using a hollow-fiber oxygenator at our institution; the mean age of this population was 61 ± 10 years; 977 patients were men (74.6%). Of these patients, 73.5% (963/1310) underwent coronary, 21.5% (281/1310) valve, and 5% (66/1310) combined surgery. Two hundred seventy-six (21.1%) needed donor blood product transfusions, while 153 (11.7%) patients underwent red cell transfusions. Significant risk factors for homologous blood product exposure after multivariate logistic regression analysis were, in order of importance: (1) postoperative blood loss (O.R. = 1.0009 per mL, p = 0.0000); (2) cardiopulmonary bypass (CPB) time (O.R. = 1.008 per min, p = 0.0001); (3) age at intervention (O.R. = 1.031 per calendar year, p = 0.0026); and (4) reoperation for bleeding (O.R. = 1.71, p = 0.0078). Protective factors were: (1) male gender (O.R. = 0.56, p = 0.0000); (2) preoperative withdrawal of autologous blood (O.R. = 0.66, p = 0.0016); and (3) a preoperative hematocrit greater than 34% (O.R. = 0.76, p = 0.005). When considering risk factors only for donor red cell exposure, multivariate regression analysis identified the following risk factors: (1) reoperations for bleeding (O.R. = 2.04, p = 0.0002); (2) postoperative blood losses (O.R. = 1.0007 per mL, p = 0.0005); (3) CPB time (O.R. = 1.0075 per min, p = 0.0008); and (4) age at intervention (O.R. = 1.03 per calendar year, p = 0.0160). Protective factors were: (1) intraoperative 'high-dose' aprotinin administration (O.R. = 0.61, p = 0.0024); and (2) preoperative donation if autologous blood (O.R. = 0.65, p = 0.0093); and (3) intraoperative withdrawal of autologous blood by phlebotomy (O.R. = 0.67, p = 0.0114). Applying multiple blood-saving techniques, coronary and valve procedures can now be performed with a low incidence of postoperative donor blood products and red cells exposures; autologous blood predonation and aprotinin administration were highly effective in reducing postoperative transfusion needs.
UR - http://www.scopus.com/inward/record.url?scp=0029001770&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029001770&partnerID=8YFLogxK
M3 - Article
C2 - 7626873
AN - SCOPUS:0029001770
VL - 10
SP - 227
EP - 235
JO - Journal of Cardiac Surgery
JF - Journal of Cardiac Surgery
SN - 0886-0440
IS - 3
ER -