• J Clin Anesth · May 1996

    Clinical Trial Controlled Clinical Trial

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

    • C W Whitten, P M Allison, T W Latson, R Ivy, D Burkhardt, R H Gulden, and R P Cochran.
    • Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, USA.
    • J Clin Anesth. 1996 May 1;8(3):229-35.

    Study ObjectiveTo 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.DesignProspective, with control values on each patient.SettingCardiac operating room of a major university-affiliated county hospital.Patients20 patients undergoing elective CABG surgery.InterventionsFollowing 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 ResultsAutologous 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.ConclusionsSignificant 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.

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