The application of salvaged autologous blood transfusion in off-pump coronary artery bypass grafting

Objective:To investigate the clinical effect of intraoperative autologous blood salvage and transfusion in off-pump coronary artery bypass grafting(OPCABG).Methods: One hundred and twenty ASA II~III,NYHA II~III patients aged 45~68 yr undergoing elective OPCABG were enrolled in this study.The parameters such as HR,MAP,PaO2,Hb,Hct,PLT,ACT and PT were observed before and during the operation.The venous blood samples were gained before the operation and after autologous blood transfusion respectively.The salvaged RBCs were examined by microscope to find their morphological changes before infused to the patients.The hemoglobin in patients' urine samples were monitored within 3 hours after the autologous blood transfused.Results: Before transfusion,MAP decreased while HR increased slightly,and after transfusion both of them were recovered to their preoperative level;Before transfusion,Hb,Hct and PLT were significantly decreased and PT were also prolonged.While after transfusion,Hb and Hct were greatly improved.After transfusion PLT and PT were still in the normal range,there was no significant variation.After transfusion,ACT were slightly decreased,but there was no statistical significance when compare with its preoperative level.Abnomal RBCs' shape were observed on washed red blood cell smear(4 ~ 6/HPF),accounting for 15% to 25% of the total RBCs' amount.But after transfusion,the morphology of the red cells was normal roughly,few of them were deformed and none was fragmented.Only 3 patients' results of uHB testing showed weakly positive and the hemoglobinuria ratio was 2.5%.Conclusion: Intraoperative autologous blood salvage and transfusion is very useful on blood conservation,which can salvage the blood effectively and be feasible to use in OPCABG.