Effect of washed autologous blood transfusion on cerebral oxygen metabolism in patients with off-pump coronary artery bypass surgery / 中国现代医生

ABSTRACT

Objective To investigate the effect of washed autologous blood transfusion on cerebral oxygen metabolism in patients with off-pump coronary artery bypass surgery. Methods 60 patients who would undergo off-pump coronary artery bypass surgery were randomly divided into control group and observation group. The control group received allogeneic blood as needed. The observation group received washed autologous blood transfusion and the right amount of allogeneic blood as needed. Blood were collected from the internal jugular vein and the radial artery before surgery(Ti), at the end of the surgery (T2) and 24 h after the surgery (T3) to perform blood gas analysis, in order to calculate indexes of CER02, Sjv02, Da-jv02 and VADL. Cases and amount of allogeneic transfusion were recorded during operation and 24 h after the surgery. Postoperative cognitive dysfunction (POCD) was assessed by postoperative simple intelligent examination method on the first day before operation and 1, 3 and 7 days after operation. Results The cases and amount of allogeneic transfusion in the observation group were significantly lower than those in the control group. The incidence of POCD in the observation group was significantly lower than the control group. Da-jv02 and CERO2 at T1, T2 and T3 in the control group showed no significant difference. Da-jv02 and CER02 of the observation group in T2 and T3 were significantly lower than T1 and control group(P＜0. 05). Sjv02 in control group was significantly higher in T2 than T1, and Sjv02 in T2 and T3 in observation group were significantly higher than Tl and control group (P＜0. 05). There was no significant difference in VADL between the two groups(P＞0. 05). Conclusion The application of washed autologous blood transfusion in off-pump coronary artery bypass surgery can effectively maintain the circulation stability, reduce allogeneic transfusion, increase oxygen supply to brain tissue and reduce cerebral oxygen consumption.