EAN: 9783662061213

BLOOD USE IN CARDIAC SURGERY KARTONIERT (TB)

Cardiac surgery has developed dramatically since the first open-he art operations were
performed in the mid 1950s. Although the improvement of surgical technique  extracorporeal
circulation  and postoperative management has contributed to a marked reduction of morbidity
and mortality  the development of cardiac surgery to its present state would not have been
possible without blood substitution by homologous donor blood. Only 20 years ago  open-heart
operations required an average of 8 units of blood preserves. The excessive need of donor blood
in those early days was mainly due to premature surgical technique  insecure control of
anticoagulation  severe blood trauma by extracorporeal circulation  and the lack of
retransfusion technologies that would have allowed the reuse of shed mediastinal blood. The
introduction of new technologies  such as normovolemic hemodilution  in traoperative
autotransfusion  postoperative return of shed mediastinal blood  and predonation of autologous
blood has greatly reduced donor blood requirements. At present the majority of routine coronary
artery surgical procedures can be performed without any blood transfusion. Blood loss  however
may be considerable in patients undergoing complex valve surgery or reoperations  as they often
require several units of transfused blood. Blood conservation has now become an area of major
interest for the cardiac surgeon. This increased concern is caused by infectious complications
of blood transfusion  in particular hepatitis and  more recently  AIDS.

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