Journal of cardiac surgery
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Randomized Controlled Trial Clinical Trial
Autotransfusion after coronary artery bypass surgery: is there any benefit?
Postoperative salvage autotransfusion of shed mediastinal blood, using the cardiotomy reservoir, is an inexpensive technique whose efficacy and safety are evaluated in this study. We randomized 75 consecutive patients into two groups. The autotransfusion group (n = 42) received autotransfusion after the completion of the coronary artery bypass grafting (CABG) until the drainage was < or = 50 mL per hour for 2 consecutive hours. ⋯ More febrile patients were seen in the autotransfusion group although not significantly more than the controls. The autotransfusion group received more red cells than the control group, but it lost more red cells in the mediastinal drains. In conclusion, the autotransfusion of shed mediastinal blood has not proved beneficial in reducing the postoperative requirements in homologous blood in patients undergoing coronary artery bypass grafting (CABG).
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Randomized Controlled Trial Clinical Trial
The effect of prophylactic nitroglycerin infusion on the incidence of regional wall-motion abnormalities and ST segment changes in patients undergoing coronary artery bypass surgery.
The effects of nitroglycerin (NTG) on regional wall-motion abnormalities, ST segment changes, and the incidence of myocardial infarction (MI), cardiac failure, and mortality were studied in 30 patients undergoing coronary artery bypass. Patients received continuous infusions of either normal saline or NTG (1 microgram/kg per min [low dose] or 2 micrograms/kg per min [high dose]) beginning at anesthesia and continuing for 4 hours postoperatively. ⋯ There were no significant differences between the control and NTG groups with regard to the incidence of Holter ST segment events or the incidence of MI, cardiac failure, or cardiac death. NTG reduced the incidence of echocardiographic wall-motion abnormalities in a dose dependent manner while having no significant effect on other parameters examined.