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Sci J Iran Blood Transfus Organ 2015, 12(1): 63-69 |
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Assar O, Kalantar Motamedi M, Lotfian I, Shakeri V, Ghiasi S, Salesi M. Multimodality blood conservation program: toward an experience of coronary artery graft surgery without blood transfusion . Sci J Iran Blood Transfus Organ 2015; 12 (1) :63-69
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URL: http://bloodjournal.ir/article-1-815-en.html
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| Abstract (HTML) (6573 Views)
Multimodality blood conservation program: toward
an experience of coronary artery graft surgery without
blood transfusion
Assar O.1, Kalantar Motamedi M.H.2, Lotfian I.3, Shakeri V.4, Ghiasi S.4, Salesi M.2
1Alborz University of Medical Sciences, Karaj, Iran
2Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
3Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
4Jamaran Heart Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran
Abstract
Background and Objectives
Blood transfusion rate for coronary artery bypass grafting (CABG) accounts for more than 10%
of all blood consumption. Studies have showed that combination of blood conservation methods
together with the multimodality programs can reduce blood transfusion during the cardiac
surgery. The aim of this study was to perform an audit of blood transfusion, determine the
predictors of transfusion in CABG operation, and compare the predicted and injeced rate of blood
transfusion as a method of quality assurance.
Materials and Methods
In this prospective observational study, 105 consecutive patients at Jamaran Heart Hospital from September 2012 to January 2013 were included. They were undergoing isolated, primary CABG by a single surgical team. The team were following a multimodality blood conservation strategy
Results
The predicted and injected blood rates were 24.1% and 13.3%, respectively. (OR = 0.48, CI = 0.26-1.4). Only 2% of patients required 2 units of packed cell and nobody received more than 2
units of blood. Low patient weight (p = 0.010) and female gender (p = 0.032) were determined as two significant predictors of blood consumption.
Conclusions
Multimodality blood conservation program can reduce blood transfusion in the CABG operation.
Thus, in the current era open heart surgery without blood transfusion is possible.
Key words: Coronary Artery Bypass, Blood Transfusion, Cardiac Surgical Procedures, Blood
Received: 19 Nov 2013
Accepted: 16 Aug 2014
Correspondence: Lotfian I., MD. General Physician of Health Research Center, Baqiyatallah University of Medical Sciences.
P.O.Box: 14359-16471, Tehran, Iran. Tel: (+9821) 82482493; Fax: (+9821) 86600062
E-mail: iman.lotfian@yahoo.com
Full-Text: (1586 Views)
References :
- Elmistekawy EM, Errett L, Fawzy HF. Predictors of packed red cell transfusion after isolated primary coronary artery bypass grafting--the experience of a single cardiac center: a prospective observational study. J Cardiothorac Surg 2009; 4: 20.
- Alghamdi AA, Davis A, Brister S, Corey P, Logan A. Development and validation of Transfusion Risk Understanding Scoring Tool (TRUST) to stratify cardiac surgery patients according to their blood transfusion needs. Transfusion 2006; 46(7): 1120-9.
- Helm RE, Rosengart TK, Gomez M, Klemperer JD, DeBois WJ, Velasco F, et al. Comprehensive multimodality blood conservation: 100 consecutive CABG operations without transfusion. Ann Thorac Surg 1998; 65(1): 125-36.
- Rosengart TK, DeBois W, O'Hara M, Helm R, Gomez M, Lang SJ, et al. Retrograde autologous priming for cardiopulmonary bypass: a safe and effective means of decreasing hemodilution and transfusion requirements. J Thorac Cardiovasc Surg 1998; 115(2): 426-38.
- Society of Thoracic Surgeons Blood Conservation Guideline Task Force, Ferraris VA, Ferraris SP, Saha SP, Hessel EA 2nd, Haan CK, et al. Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists clinical practice guideline. Ann Thorac Surg 2007; 83(5 Suppl): S27-S86.
- Society of Thoracic Surgeons Blood Conservation Guideline Task Force, Ferraris VA, Brown JR,
- Bennett-Guerrero E, Zhao Y, O'Brien SM, Ferguson Jr T, Peterson ED, Gammie JS, et al. Variation in use of blood transfusion in coronary artery bypass graft surgery. JAMA 2010; 304(14): 1568-75.
- Reddy SM, Talwar S, Velayoudam D, Gharde P, Mallick V, Jha RK, et al. Multi-modality blood conservation strategy in open-heart surgery: an audit. Interact Cardiovasc Thorac Surg 2009; 9(3): 480-2.
- Brevig J, McDonald J, Zelinka ES, Gallagher T, Jin R, Grunkemeier GL. Blood transfusion reduction in cardiac surgery: multidisciplinary approach at a community hospital. Ann Thorac Surg 2009; 87(2): 532-9.
- Keramati MR, Nezafati MH, Sadeghian MH. Multivariate predictors of blood transfusion in patients undergoing coronary artery bypass graft surgery. Sci J Iran Blood Transfus Organ 2008; 5(1): 1-8. [Article in Farsi]
- Junod FL, Harlan BJ, Payne J, Smeloff EA, Miller GE, Kelly PB, et al. Preoperative risk assessment in cardiac surgery: comparison of predicted and observed results. Ann Thorac Surg 1987; 43(1): 59-64.
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Multimodality blood conservation program: toward
an experience of coronary artery graft surgery without
blood transfusion
Assar O.1, Kalantar Motamedi M.H.2, Lotfian I.3, Shakeri V.4, Ghiasi S.4, Salesi M.2
1Alborz University of Medical Sciences, Karaj, Iran
2Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
3Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
4Jamaran Heart Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran
Abstract
Background and Objectives
Blood transfusion rate for coronary artery bypass grafting (CABG) accounts for more than 10%
of all blood consumption. Studies have showed that combination of blood conservation methods
together with the multimodality programs can reduce blood transfusion during the cardiac
surgery. The aim of this study was to perform an audit of blood transfusion, determine the
predictors of transfusion in CABG operation, and compare the predicted and injeced rate of blood
transfusion as a method of quality assurance.
Materials and Methods
In this prospective observational study, 105 consecutive patients at Jamaran Heart Hospital from September 2012 to January 2013 were included. They were undergoing isolated, primary CABG by a single surgical team. The team were following a multimodality blood conservation strategy
Results
The predicted and injected blood rates were 24.1% and 13.3%, respectively. (OR = 0.48, CI = 0.26-1.4). Only 2% of patients required 2 units of packed cell and nobody received more than 2
units of blood. Low patient weight (p = 0.010) and female gender (p = 0.032) were determined as two significant predictors of blood consumption.
Conclusions
Multimodality blood conservation program can reduce blood transfusion in the CABG operation.
Thus, in the current era open heart surgery without blood transfusion is possible.
Key words: Coronary Artery Bypass, Blood Transfusion, Cardiac Surgical Procedures, Blood
Received: 19 Nov 2013
Accepted: 16 Aug 2014
Correspondence: Lotfian I., MD. General Physician of Health Research Center, Baqiyatallah University of Medical Sciences.
P.O.Box: 14359-16471, Tehran, Iran. Tel: (+9821) 82482493; Fax: (+9821) 86600062
E-mail: iman.lotfian@yahoo.com
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