Zhongguo shuxue zazhi (Jan 2024)
Autologous blood transfusion during heart valve replacement surgery: a retrospective study
Abstract
Objective To retrospectively analyze the indexes of autologous blood transfusion during heart valve replacement, in order to provide reference for allogeneic blood transfusion during heart valve replacement surgery under direct vision. Methods The data of 180 patients who underwent heart valve replacement in our hospital from January 2020 to December 2021 were analyzed retrospectively. The patients were divided into allogeneic and non-allogeneic blood transfusion group based on whether allogeneic blood was transfused during the operation, and the general data and 24 hours pre- and post-operative clinical examination indexes were compared. Results Multivariate logistic regression analysis showed that age (OR=1.110, 95% CI: 1.058-1.165, P<0.05) and intraoperative cardiopulmonary bypass time (OR=1.062, 95% CI: 1.038-1.086, P<0.05) were risk factors for allogeneic blood transfusion, and preoperative Hb content (OR=0.910, 95%CI: 0.868-0.953, P<0.05) was a protective factor. The RBC count(4.16±0.73 vs 4.52±0.71)×1012/L and Hb(120.94±17.97 vs 136.57±19.33) g/L at 24 hours preoperative in the allogeneic transfusion group were lower than those in the non-allogeneic transfusion group, and the RBC(3.51±0.53 vs 4.13±0.78)×1012/L, Hb(114.15±11.68 vs 124.79±14.96)g/L and platelet count(124.28±32.11 vs 148.29±26.62)×109/L at 24 hours postoperative were significantly lower than those in the non-allogeneic transfusion group (P<0.05). Conclusion Age and intraoperative cardiopulmonary bypass time are the risk factors for autologous and allogeneic blood transfusion during heart valve replacement under direct vision, and the preoperative Hb content is a protective factor. It is necessary to evaluate the symptomatic treatment of patients before operation and reduce allogeneic blood transfusion.
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