Experience Of 516 Adult Cardiovascular Surgeries Without Blood Transfusion

With the rapid development of medical service in china,the number of patients with clinical medical treatment has been increasing in recent years,especially in surgical operation.At present,our country completes more than 160,000 cases in the heart surgery every year and the blood transfusion rate >70%,which has brought the huge pressure to the clinical blood supply.At the same time,blood transfusion can cause a variety of transfusion reactions,blood transfusion complications and blood transfusion-related infectious diseases.Some studies have shown that blood transfusion is an independent risk factor for cardiac surgery morbidity and mortality.These have increased the indirect cost of blood transfusion and have affect patients and hospitals adversely.Since 2014,our center has gradually and systematically applied the technique of transfusion-free surgery to cardiovascular surgery and has achieved good clinical results through multidisciplinary cooperation in cardiovascular surgery department,anesthesiology department,extracorporeal circulation department and blood transfusion department.This paper summarize the clinical experience of no blood operation technique in cardiovascular surgery,which based on the clinical data of no blood transfusion operation in our center.we hope to improve the related measures of hematological protection and blood management,to enlarge the indication of no transfusion operation,,to relieve the pressure of blood source tension,to avoid the occurrence of blood-borne infectious diseases,and to Further reduce the clinical blood volume.Objective:To summarize the clinical experience of no blood transfusion(allogeneic blood)in adult surgery of cardiovascular surgery.Methods:Excluding the patients with severe preoperative infection,significant anemia,coagulation dysfunction,liver and kidney insufficiency,reoperation or large vessel surgery,648 patients with coronary artery bypass grafting,cardiac valvular surgery,Congenital heart disease orthopedics and cardiac myxoma surgery were treated between January 2014 to June 2015 at cardiovascular surgery department of 2nd hospital of Jilin University.Perioperative application of the center’s mature blood protection technology.Retrospective study of postoperative hemoglobin content,postoperative mean corpuscular volume,postoperative 24 hours drainage,extubation time,ICU days and total hospitalization days.Result:516 of 648 surgeries were complished without blood transfusion and the rate without blood transfusion was 79.6%.In no blood transfusion group,postoperative hemoglobin was(11.13 ±1.5)g /l,mean corpuscular volume was(32.83 ±4.49)%,postoperative 24 hours drainage was(255.9±64.6)ml,extubation time was(7.89±3.02)hours,ICU stay was(30.56±23.54)hours.total hospitalization days was(11.17±3.37)days.Conclusion:Perioperative comprehensive use of various blood protection technology and multidisciplinary implementation of a unified blood transfusion standards can reduce or even avoid unnecessary blood transfusion,prevent transfusion reactions,blood transfusion complications and blood transfusion-related infectious diseases.The application of no blood transfusion surgery in adult cardiovascular surgery is safe and feasible.