ORIGINAL ARTICLE   

Chirurgia 2019 October;32(5):231-5

DOI: 10.23736/S0394-9508.18.04904-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Management of bleeding and blood transfusion in open cardiac surgery in a developing country: five-years institutional experience

Ikechukwu A. NWAFOR ✉, John C. EZE

National Cardiothoracic Center of Excellence (NCTCE), University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria

BACKGROUND: Major bleeding and blood loss is an unavoidable consequence of open cardiac surgery. However, excessive and uncontrolled bleeding is a complication which may have a negative impact on patient outcomes except good perioperative patient blood management is undertaken. The aim of this study was to review our local experiences on the management of bleeding and blood transfusions in open cardiac surgery.
METHODS: In a period of 5 years (March, 2013 to February, 2018), we performed a retrospective review of patients that underwent open cardiac surgery in our center. The data was obtained from the hospital information technology department. Data comprised patients’ demographics, types of cardiac surgery procedures, units of blood and blood products transfused including the use of cell saver techniques as well as perioperative patient blood management strategies.
RESULTS: 162 cardiac surgeries were performed in 137 patients with a mean of 36.8 cases in a year. There were 73 (53.28%) males and 54 (39.42%) females with a ratio of 1:0.7. Averagely 394 units of whole blood, 158 units of packed cell, 178 units of FFP and 81 units of platelet concentrate were transfused. Age of patients ranged from <1-70 years. The highest number of indications for cardiac surgery done was mitral valve disease, with (N.=44, 26.67%).
CONCLUSIONS: Cardiac surgery worldwide consumes allogeneic blood. However, patient blood management improves outcome through the application of evidence based surgical and point-of-care tests strategies that optimize and conserve patients’ own blood and limit transfusion to specific components of blood lost.

KEY WORDS: Hemorrage; Blood; Cardiac surgical procedures