Impact of three blood saving strategies on the decrease of allogenic transfusion at the Guayaquil Clinic. Four-year valuation.

Abstract

Abstract:

Introduction: Blood saving techniques in the field of cardiac surgery under extracorporeal circulation (CPC) have become more relevant in recent years due to studies that demonstrate complications derived from allogeneic blood transfusions.

Materials and methods: Retrospective observational study, 358 patients were studied between 2020 and 2023, divided into two homogeneous groups of 179 patients. Group A: no blood saving strategy was applied, Group B: One, two or more strategies were administered. The strategies used in this study were: Normovolemic hemodilution (NVHD), Anterograde Hematopoietic Repriming (HAR), reduction of venous tubing size to 3/8 in patients with body surface <1.5m2.

Results: The mean Hb at baseline was 11.9 gr/dl in group A and 11.5 gr/dl in group B. There were no significant differences in terms of whether or not transfusion was performed (p=1.000); however, there was a significant difference in the reduction of the number of units transfused in group B (p 0.025).

Conclusions: HAR and HDNVA showed good results in reducing hemodilution, considering that in the latter only 19 patients were treated. Reducing the venous line to 3/8 did not prove to be efficient on its own. These strategies can be applied individually or in combination; however, it was shown that their benefit increases when more than one strategy is performed.

Keywords: Blood-saving strategies, HAR, HNVA, Cardiac surgery, hemodilution, blood transfusion