Cardiac revascularization without using cardiopulmonary bypass reduces total usage of blood products and perioperative bleeding

Nader Nader-Djalal, W. Z. Khadra, A. L. Panos, Tomas Salerno, D. R. Bacon

Research output: Contribution to journalArticle

Abstract

Purpose: To study the difference in the requirement of the blood products (i.e., packed red blood cells, fresh frozen plasma, and platelets) and perioperative bleeding during the course of coronary artery bypass surgery performed with or without CPB. Methods: Retrospectively, we reviewed the charts of 106 patients who underwent CABG procedure in our medical center. Fifty-nine patients had CABG without CPB and 47 patients underwent CPB for revascularization procedure. Total unit number of PRBC, FFP, and platelets and cryoprecipitate that were used during admission for this surgery for any given patient was electronically acquired and recorded. Pre and post-operative coagulation profile (i.e., PT, PTT, ACT, Platelet count, and the use of aspirin and heparin) were also recorded. Hemoglobin concentrations were also recorded before and after surgery. Data were analyzed using unpaired Student's t-test. Results: Demographic data (age, ASA status and LV function grade) were similar between two groups. Average age was 62.8+/- 2.8 years. Despite of the higher number of patients receiving heparin at the time of surgery and mild elevation of preoperative PTT and ACT (40.4 +/- 2.9, 150.1+/- 5.3), the group of patients who did not undergo CPB had less perioperative (intra-operative + postoperative) bleeding (2371+/- 268 ml vs. 3233+/- 166 ml, p<0.05) and required less blood products PRBC (2.38+/- 0.62 vs 4.83+/- 0.82 units), FFP (0.91+/- 0.25 vs 2.55+/-0.51units) and platelets (2.05+/- 0.91vs. 5.80+/-1.2 units) when compared to the group of patients with CPB. (p<0.05) Conclusions: Avoiding CPB for coronary revascularization offers savings in the usage of blood products and may decrease the risk of transmitting blood-borne pathogens in patients undergoing CABG procedures. Clinical Implications: With the advent of new techniques, myocardial revascularization is possible without a need for use of CPB. This may decrease the risk or bleeding in these patients and the requirement for transfusion and its associated risks.

Original languageEnglish
JournalChest
Volume114
Issue number4 SUPPL.
StatePublished - Oct 1 1998
Externally publishedYes

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Cardiopulmonary Bypass
Hemorrhage
Blood Platelets
Heparin
Blood-Borne Pathogens
Myocardial Revascularization
Platelet Count
Coronary Artery Bypass
Aspirin
Hemoglobins
Erythrocytes
Demography
Students

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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Cardiac revascularization without using cardiopulmonary bypass reduces total usage of blood products and perioperative bleeding. / Nader-Djalal, Nader; Khadra, W. Z.; Panos, A. L.; Salerno, Tomas; Bacon, D. R.

In: Chest, Vol. 114, No. 4 SUPPL., 01.10.1998.

Research output: Contribution to journalArticle

Nader-Djalal, Nader ; Khadra, W. Z. ; Panos, A. L. ; Salerno, Tomas ; Bacon, D. R. / Cardiac revascularization without using cardiopulmonary bypass reduces total usage of blood products and perioperative bleeding. In: Chest. 1998 ; Vol. 114, No. 4 SUPPL.
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abstract = "Purpose: To study the difference in the requirement of the blood products (i.e., packed red blood cells, fresh frozen plasma, and platelets) and perioperative bleeding during the course of coronary artery bypass surgery performed with or without CPB. Methods: Retrospectively, we reviewed the charts of 106 patients who underwent CABG procedure in our medical center. Fifty-nine patients had CABG without CPB and 47 patients underwent CPB for revascularization procedure. Total unit number of PRBC, FFP, and platelets and cryoprecipitate that were used during admission for this surgery for any given patient was electronically acquired and recorded. Pre and post-operative coagulation profile (i.e., PT, PTT, ACT, Platelet count, and the use of aspirin and heparin) were also recorded. Hemoglobin concentrations were also recorded before and after surgery. Data were analyzed using unpaired Student's t-test. Results: Demographic data (age, ASA status and LV function grade) were similar between two groups. Average age was 62.8+/- 2.8 years. Despite of the higher number of patients receiving heparin at the time of surgery and mild elevation of preoperative PTT and ACT (40.4 +/- 2.9, 150.1+/- 5.3), the group of patients who did not undergo CPB had less perioperative (intra-operative + postoperative) bleeding (2371+/- 268 ml vs. 3233+/- 166 ml, p<0.05) and required less blood products PRBC (2.38+/- 0.62 vs 4.83+/- 0.82 units), FFP (0.91+/- 0.25 vs 2.55+/-0.51units) and platelets (2.05+/- 0.91vs. 5.80+/-1.2 units) when compared to the group of patients with CPB. (p<0.05) Conclusions: Avoiding CPB for coronary revascularization offers savings in the usage of blood products and may decrease the risk of transmitting blood-borne pathogens in patients undergoing CABG procedures. Clinical Implications: With the advent of new techniques, myocardial revascularization is possible without a need for use of CPB. This may decrease the risk or bleeding in these patients and the requirement for transfusion and its associated risks.",
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AU - Nader-Djalal, Nader

AU - Khadra, W. Z.

AU - Panos, A. L.

AU - Salerno, Tomas

AU - Bacon, D. R.

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N2 - Purpose: To study the difference in the requirement of the blood products (i.e., packed red blood cells, fresh frozen plasma, and platelets) and perioperative bleeding during the course of coronary artery bypass surgery performed with or without CPB. Methods: Retrospectively, we reviewed the charts of 106 patients who underwent CABG procedure in our medical center. Fifty-nine patients had CABG without CPB and 47 patients underwent CPB for revascularization procedure. Total unit number of PRBC, FFP, and platelets and cryoprecipitate that were used during admission for this surgery for any given patient was electronically acquired and recorded. Pre and post-operative coagulation profile (i.e., PT, PTT, ACT, Platelet count, and the use of aspirin and heparin) were also recorded. Hemoglobin concentrations were also recorded before and after surgery. Data were analyzed using unpaired Student's t-test. Results: Demographic data (age, ASA status and LV function grade) were similar between two groups. Average age was 62.8+/- 2.8 years. Despite of the higher number of patients receiving heparin at the time of surgery and mild elevation of preoperative PTT and ACT (40.4 +/- 2.9, 150.1+/- 5.3), the group of patients who did not undergo CPB had less perioperative (intra-operative + postoperative) bleeding (2371+/- 268 ml vs. 3233+/- 166 ml, p<0.05) and required less blood products PRBC (2.38+/- 0.62 vs 4.83+/- 0.82 units), FFP (0.91+/- 0.25 vs 2.55+/-0.51units) and platelets (2.05+/- 0.91vs. 5.80+/-1.2 units) when compared to the group of patients with CPB. (p<0.05) Conclusions: Avoiding CPB for coronary revascularization offers savings in the usage of blood products and may decrease the risk of transmitting blood-borne pathogens in patients undergoing CABG procedures. Clinical Implications: With the advent of new techniques, myocardial revascularization is possible without a need for use of CPB. This may decrease the risk or bleeding in these patients and the requirement for transfusion and its associated risks.

AB - Purpose: To study the difference in the requirement of the blood products (i.e., packed red blood cells, fresh frozen plasma, and platelets) and perioperative bleeding during the course of coronary artery bypass surgery performed with or without CPB. Methods: Retrospectively, we reviewed the charts of 106 patients who underwent CABG procedure in our medical center. Fifty-nine patients had CABG without CPB and 47 patients underwent CPB for revascularization procedure. Total unit number of PRBC, FFP, and platelets and cryoprecipitate that were used during admission for this surgery for any given patient was electronically acquired and recorded. Pre and post-operative coagulation profile (i.e., PT, PTT, ACT, Platelet count, and the use of aspirin and heparin) were also recorded. Hemoglobin concentrations were also recorded before and after surgery. Data were analyzed using unpaired Student's t-test. Results: Demographic data (age, ASA status and LV function grade) were similar between two groups. Average age was 62.8+/- 2.8 years. Despite of the higher number of patients receiving heparin at the time of surgery and mild elevation of preoperative PTT and ACT (40.4 +/- 2.9, 150.1+/- 5.3), the group of patients who did not undergo CPB had less perioperative (intra-operative + postoperative) bleeding (2371+/- 268 ml vs. 3233+/- 166 ml, p<0.05) and required less blood products PRBC (2.38+/- 0.62 vs 4.83+/- 0.82 units), FFP (0.91+/- 0.25 vs 2.55+/-0.51units) and platelets (2.05+/- 0.91vs. 5.80+/-1.2 units) when compared to the group of patients with CPB. (p<0.05) Conclusions: Avoiding CPB for coronary revascularization offers savings in the usage of blood products and may decrease the risk of transmitting blood-borne pathogens in patients undergoing CABG procedures. Clinical Implications: With the advent of new techniques, myocardial revascularization is possible without a need for use of CPB. This may decrease the risk or bleeding in these patients and the requirement for transfusion and its associated risks.

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