Dedinje Cardiovascular Institute, Serbia
Title: Blood loss and intraoperative salvage procedure in patients underwent re-operation coronary artery bypass
Vera Maravic-Stojkovic has completed his Ph.D. at the age of 41 years from Belgrade University and postdoctoral studies from Medizinicshe Hochcshule Hannover, Germany. She is the Head of Laboratory Services in Dedinje Cardiovascular Institute, Belgrade Serbia. She has published more than 25 papers in reputed journals and has been serving as a member of the Heart and Liver Transplant Team in Serbia.
Preoperative patients` characteristics can predict the need for perioperative blood component transfusion in cardiac operations. Currently, a large number of patients are on antiplatelet therapy. A group of these patients required re-operation (redo) aft er coronary artery bypass (CABG). We aimed to compare blood loss in patients having CABG with patients undergoing redo CABG. Fift y-four patients (16% female, 84% male; ages 60.5 ± 6 vs. 66.2 ± 7 years) were divided in: Group 1-CABG, and Group 2-redo CABG. Blood samples were collected: 24h prior, 6h and 24h aft er operation. We measured hematological parameters and total amount of blood products substituted. Preoperative hemoglobin (p = 0.44) and aspirin therapy were not statistically signifi cant (p = 0.116), while preoperative platelet count (0.0004) was signifi cantly lower in Group 2. Although we found some diff erence in blood drainage (868.5 ± 587.5 vs. 1040 ± 823.44) it was not statistically relevant (p = 0.422). Allogeneic erythrocytes substituted intraoperatively was not statistically diff erent (p = 0.611), while autologous blood salvage procedure was important (p = 0.005) in Group 2. Platelets transfused (p = 0.886), fresh frozen plasma (p = 0.681), and packed red blood cells transfused postoperatively (p = 0.324) have not reach statistical diff erence. Length of stay in intensive care unit (ICU) was not infl uenced by used blood components transfusion, either allogeneic or autologous. We have found positive correlation between blood loss and ICU stay (r = 0.49, p = 0.021). Monitoring of these markers off ers an important addition to the preoperative risk assessment.