The Use of Hemodilution and Fresh Autologous Blood in Open-Heart Surgery

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Abstract
Three hundred patients were randomly selected and comprised two statistically balanced groups of 150 each. Group I received fresh autologous transfusions following extracorpeal circulation and homologous whole bank blood when further blood replacement was necessary. Group II served as controls, receiving whole bank blood following extracorporeal circulation and again when further blood replacement was necessary. Both groups were hemodiluted during bypass. The total amount of whole bank blood required during the hospital stay in group I was significantly less than in group II. There was no significant change in the preoperative and postoperative determinations of partial thromboplastin time, clotting time or prothrombin time in group I patients. These same time tests were increased in group II patients but were not clinically significant, attesting to the efficacy of a relatively brief period of extracorporeal circulation. Platelet counts and fibrinogen levels decreased during cardiopulmonary bypass in group I patients but increased immediately with reinfusion of the fresh autologous blood. An improved technic of hemospasia is described which reduces the demand for bank blood by roughly 50 percent.

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