| Feasibility of blood conservation strategies in pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. | |
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MedLine Citation:
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PMID: 21422156 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Blood transfusion requirements were reviewed for a consecutive series of 25 patients undergoing elective pulmonary endarterectomy (PEA) between August 2005 and March 2009 in our institution. Patients were divided into two groups based on the implementation of a conservative blood transfusion algorithm that combined antifibrinolytic therapy, intraoperative blood sequestration, blood salvage and lack of correction of coagulation parameters in the absence of ongoing bleeding. Despite similar perioperative coagulation profiles in the two groups, the introduction of a conservative blood transfusion algorithm was associated with a significant increase in the number of patients receiving no homologous blood products. Of 16 patients who underwent surgery after the introduction of the algorithm, nine (56%) required no homologous blood products and five (31%) required one or two units of homologous red blood cells only. The international normalized ratio normalized within six to 12 hours after discontinuation of cardiopulmonary bypass without transfusion of fresh frozen plasma or platelets in 13 of the 16 patients. In conclusion, a conservative blood transfusion strategy allows PEA to be safely performed with no or minimal blood product transfusions in a majority of patients despite deep hypothermic circulatory arrest. Keywords: Pulmonary thromboendarterectomy; Pulmonary endarterectomy; Transfusion. |
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Authors:
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Karen McRae; Yaron Shargall; Martin Ma; John Thenganatt; Peter Slinger; John T Granton; Marc de Perrot |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-21 |
Journal Detail:
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Title: Interactive cardiovascular and thoracic surgery Volume: - ISSN: 1569-9285 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Anesthesia and Pain Management, Toronto General Hospital, University of Toronto, Toronto, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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