Objective To investigate the risk factors of perioperative red blood cells transfusion for coronary artery bypass grafting (CABG) surgery. Method We retrospectively analyzed the clinical data of 534 patients underwent CABG in our hospital from January to March 2014 year. Those patients were divided into two groups:an on-pump coronary artery bypass grafting group (on-pump group) and an off-pump coronary artery bypass grafting group (off-pump group). There were 185 males and 54 females with a mean age of 59.1±9.4 years in the on-pump group. There were 233 males and 62 females with a mean age of 60.3±8.5 years in the off-pump group. Preoperative data, the relative parameters of extracorporeal circulation, the quantity of red blood cells transfusion of those two groups were compared. risk factors associated with red blood cells transfusion were evaluated by multivariate logistic regression analysis. Results The risk factors of perioperative red blood cells transfusion were age (OR=1.04, 95% CI 1.02-1.07, P=0.001) , weight (OR=0.95, 95% CI 0.93-0.97, P<0.001) , smoking (OR=0.61, 95% CI 0.39-0.94, P=0.027) , preoperative level of HCT (OR=0.90, 95% CI 0.85-0.96, P=0.001) and cardiopulmonary bypass (CPB) (OR=4.90, 95% CI 3.11-7.71, P<0.001) . During CPB, the nadir hemoglobin (nHb) (OR=0.63, 95% CI 0.47-0.84, P=0.002) was the only independent risk factor of red blood cell transfusion. Conclusions Age, weight, non-smoking, preoperative level of HCT, CPB are the risk factors for patients underwent CABG perioperatively and the lowest level of Hb in CPB is an independent risk factor of perioperative red blood cells transfusion.
ObjectiveTo evaluate the effects of leukocyte filtration (LF) on blood components and cytokines of residual pump blood after cardiopulmonary bypass (CPB). MethodsForty patients who underwent selective cardiac surgery with CPB in Fu wai Hospital from December 2012 to February 2013 were included in this study. There were 34 male and 6 female patients with their age of 16-72 years. All the patients were randomly divided into an experimental group and a control group. In the experimental group, patients received residual pump blood transfusion which had been processed with LF and stored in sterile blood collection bags. In the control group, patients received residual pump blood transfusion which was stored in sterile blood collection bags without LF process after CPB. Blood samples were taken before CPB (T1) at the end of CPB (T2) and 4 hours (T3) after CPB to examine blood components and concentrations of IL-6, IL-10 and TNF-α. ResultsWhite blood cell count and neutrophil count of the experimental group were significantly lower than those of the control group at T2 and T3 (P<0.05). There was no statistical difference in red blood cell count, hemoglobin,hematocrit or free hemoglobin at respective time points between the 2 groups (P>0.05). There was no statistical difference in plasma IL-6,IL-10 or TNF-α concentrations at different time points within either group (P>0.05) or at respective time points between the 2 groups (P>0.05). ConclusionLF can reduce white blood cell count and neutrophil count of residual pump blood,but does not significantly change other blood components and plasma concentrations of IL-6,IL-10 or TNF-α after CPB.