Pulmoner endarterectomy surgey i̇n blood autotransfusi̇on system and i̇ts i̇mpact on the use of homologous blood products

Introduction While observing the application ratios, it has been determined that blood transfusion has a high utilisation in the operations of open heart surgery. The tendency to use the blood protection methods has been increased in order to protect the patients from the complications of blood transfusion. The purpose of this study is to investigate the effect of autotransfusion technique utilisation during the pulmonary endarterectomy operations, which at the same time one of the autologous blood transfusion methods, on homologous blood and blood product usage. Material and method Our study is based on the investigations of retrospective data of 40 adult patients who had undergone Pulmonary Endarterectomy operation between the dates of May 2016 and May 2017, in Health Sciences University Kartal Koşuyolu High Speciality Educational and Research Hospital. Patients that have not been undergone either an open heart or pulmonary endarterectomy procedure, above the age of 18, equal or below the age of 75, not having an haematologic or malignity history have all been included in the study. Also the perfusion recordings, archive scanning of intensive care patient monitoring charts and data base scanning of the same hospital have been used. Study groups have been designed as "autotransfusion blood unused" (Group 1) and "autotransfusion blood used" (Group 2) groups, as 20 patients in each one. Results The 40 patients proper for the study conditions were randomised as 21 male (52.5%) and 19 female (47.5%). There was no statistically significant difference in regards of age and BSA (body surface area) (respectively p=0.562, p=0.130). Statistically significant difference could not be found in the parameter of preoperative Htc (haematocrit) levels (p=0.84). There was no significant difference between the groups in terms of perioperative Htc levels during 190C and 370C (respectively p=0.469, p=0.204). Perioperative blood and blood product usage average of Group 1 was significantly higher than the Group 2 (p=0.00). The mean Htc value of Group 2 in postoperative 6th hour was significantly higher than the Group 1 (p=0.01). There was no significant difference between the groups in terms of perioperative Htc levels of 12 and 24th hours (respectively p=0.083, p=0.468). Blood and blood product usage was significantly higher in Group 1 in the period of postoperative 6th hour (p=0.01). There was no significant difference between the groups in terms of postoperative 12 and 24th hour blood and blood product usages (respectively p=0.267, p=0.324). There was no significant difference between the two groups in terms of postoperative 6, 12 and 24th hour drainage amounts (respectively p=0.413, p=0.531, p=0.253). Conclusion It has been detected that the utilisation of autotransfusion device blood in Pulmonary Endarterectomy operations, including the coronary aspirator can diminish the homologous blood and blood product usage. Seperating the thrombocytes and plasma by autotransfusion does not lead to haemorrhage in the postoperative period. Also prospective randomised studies are needed correlated to other operations. Keywords: cardiopulmonary bypass, pulmonary endarterectomy, blood transfusion, blood protection, autotransfusion