Cardiac Surgery without Donor Blood Transfusion at a Referral Cardiac Institute in Bangladesh

• DOI: 10.3329/jninb.v5i1.42170
• Publication Date: 2019-07-16T06:17:26Z
• Authors: Kazi Shariful Islam; SAMA Sabur; Kazi Abul Hasan; Begum Marjan Maha...; Nilufar Yasmin; Mohammad Zahid
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

Background: Blood transfusion is always associated with some hazards despite economic and work burden on laboratory staffs. Pre-donation blood conservation can help to avoid related good posto-perative outcome.
 Objective: The main objective of this study was show the varieties cardiac surgery without donor transfusion.
 Methodology: Patients were selected conveniently. Preoperative proper counseling done guardians minor all adult patients about procedure written informed consent taken accordingly. All operated under cardio-pulmonary bypass (CPB) following a standard protocol through mid-sternotomy, systemic heparinization, antegrade intermittent cold cardioplegic arrest heart. After weaning from CPB protamine administered neutralize action heparin. A pre-operative hemoglobin (Hb) hematocrit (Hct) measured just before heparinization. One bag drawn patient’s body when Hb Hct more. Meticulous hemostasis after bypass. Both local tranexamic acid plus calcium injection given sternal wires are tighten. in machine returned at end operation. Patient’s checked detect need for transfusion. other variables studied.
 Results: Ten blood. Out ten male=5 female=5, Male:Female=1:1 age range 5-26 years mean ±SD (13±-6.88) years. Preop diagnosis ASD 4/10=40%,VSD 3/10=30% TOF 2/10=20% AVR=1/10=10%. Range: 12.4-17.3 gm/dl. Mean (14.25±-1.66 Pre-operative mean±SD (43.7±4.5). Per-operative during Mean±SD (24.9±4). Post-operative (11.25gm±1.18gm). (34.3±3.80). Use cell saver 1/8(12.5%) loss ASD,VSD, AVR = 140±20.60ml, 156.44±33.84.320.80±60.22ml 280 ml respectively. Varieties ionotropes used were: Dopamine Dobutamin Adrenaline. Single ionotrope Dopa/Dobuta5/10=50% Double Dopa/dobuta+Adrin=3/10(30%) tripple 2/10(20%). Morbidity mortality 0%. discharged home uneventfully, hospital outcome good.
 Conclusion: In our setup we do use by pre-donation conservative techniques.]
 Journal National Institute Neurosciences Bangladesh, 2019;5(1): 53-58