Original article: cardiovascularRetrograde autologous priming of the cardiopulmonary bypass circuit reduces blood transfusion after coronary artery surgery
Section snippets
Patient population
A prospective, randomized, controlled study was performed in patients presented for primary coronary artery bypass grafting (CABG). The sample size was 100 based on demonstrating a reduction in transfusion from 60% (local audit data 1999) to 40%, with a confidence level of 0.95 and a power of 0.8. After local research ethics committee approval (study reference no. 99/151; December 15, 1999) and informed consent, 104 patients were prospectively randomly assigned to control (no prime
Baseline characteristics
The groups were closely matched for age, body weight, body surface area, NYHA classification, comorbid risk factors, and preoperative hematologic data (preoperative HCT = 43% in both groups). There were significantly more female patients in the RAP group (13 of 51, 25.49%) compared with the control group (4 of 49, 8.16%; p = 0.02).
Exclusions
Four patients from the control group were excluded from the study for the following reasons: in 1 patient deep hypothermic circulatory arrest was used because of a
Comment
Coronary artery bypass graft surgery is the most commonly performed cardiac operation and as many as 70% of patients require a blood transfusion despite improvements in cardiac surgical techniques. The transfusion rate varies between institution [9]. RAP of the CPB circuit is not a new technique. In 1960, Panico and Neptune [10] first described a method of autologously priming the CPB circuit to reduce the requirements for homologous blood, which was used to prime the CPB circuit at that time.
Acknowledgments
We thank Dr Manzoor Nazir from the Yorkshire Heart Centre, United Kingdom, for his help in analyzing electrocardiographic data.
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