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Blood Loss and Intraoperative Salvage Procedure in Patients Underwent Coronary Artery Bypass Reoperative Surgery

Stojkovic B, Jovanovic T, Vukovic P, Calija B2, Milojevic P2, Maravic-Stojkovic V and Djukanovic B

Preoperative patients` characteristics can predict the need for perioperative blood component transfusion in cardiac operations. Currently, a large number of patients are on antiplatelet therapy. A group of these patients require reoperative surgery (redo) after coronary artery bypass grafting (CABG). We aimed to compare blood loss in patients having CABG with patients undergoing reoperative CABG surgery. Fifty-four patients (16% female, 84% male; ages 60.5 ± 6 vs. 66.2 ± 7 years) were divided in: Group 1–CABG, and Group 2–redo CABG. Blood samples were collected: 24h prior, 6h and 24h after the operation. We measured hematological parameters and total amount of blood products substituted. Preoperative clopidogrel and aspirin therapy were not statistically significant (p=0.094), while platelet count (p=0.002) was significantly lower in Group 2. Although we have found some differences in the blood drained (868.5 ± 587 vs. 1088 ± 819 mL) it was not statistically relevant (p=0. 28). Allogenic erythrocytes substituted intraoperatively were not statistically different (p=0.61), while autologous blood salvage procedure was weakly significant (p=0.05). Platelets transfused (p=0.88), fresh frozen plasma (p=0.68), and packed red blood cells transfused postoperatively (p=0.32) have not reached statistical significance. Length of stay in intensive care unit (ICU) was not influenced by used blood components transfusion, either allogenic or autologous. We have found positive correlation between blood loss and ICU stay (r=0.49, p=0.021). Monitoring of these parameters offers an important addition to the preoperative risk assessment.