An intraoperative autologous donation protocol used in patients during cardiac surgery was safe and effective in minimizing perioperative morbidity and mortality, according to data presented at The Society for Thoracic Surgeons Annual Meeting.
“Aggressive [intraoperative autologous donation] is an effective blood conservation strategy that leads to improved outcomes in cardiac surgery,” Eric Zimmermann, MD, resident at NewYork-Presbyterian Queens, and colleagues wrote.
Researchers analyzed data from 688 patients who underwent surgery between 2009 and 2017. Data included outcomes of patients before (n = 268; mean age, 66 years; 65% men) and after (n = 420; mean age, 64 years; 74% men) an aggressive intraoperative autologous donation protocol was implemented in the department in January 2013.
Variables included in this study were chest tube output, length of stay, packed red blood cell transfusions, type of procedure, demographics and outcomes.
Patients who underwent surgery after the protocol was implemented required fewer blood transfusions after surgery compared with those who underwent surgery before the protocol was implemented (70% vs. 40%; P < .001). In addition, these patients had shorter lengths of stay (7.8 days vs. 6.8 days; P < .001), fewer total transfusions (1.76 packed red blood cells vs. 0.79 packed red blood cells; P < .001) and lower chest tube output (1,295 mL vs. 1,207 mL; P = .038).
“We 100% agree that this is not definitive, but hope it promotes additional interest in the subject,” Zimmermann told Cardiology Today. “We hope it will motivate prospective studies to bring more scientific rigor to the subject.”
He noted that for publication, his team will perform multivariate logistic regression to determine if the effect remains after adjustment. – by Darlene Dobkowski
Zimmerman E, et al. The Multidisciplinary Team: How We Do It. Presented at: The Society for Thoracic Surgeons Annual Meeting; Jan. 27-29, 2019; San Diego.
Disclosure: Zimmermann reports receiving research grant funding from the NIH.