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Transfusion of Warm Fresh Whole Blood for Aortic Surgery


  • #PER 01-O-4
  • Perfusion. SESSION-1
  • Oral

Transfusion of Warm Fresh Whole Blood for Aortic Surgery

Toufik Hiaiche 1, Hazine Bousbah 1, Naim Bensadik 2, Bourzik Bensaadi 3, Omar Tounsi 2, Thierry Caus 4

1 University Hospital N. Hammodi, Alger, Algeria; 2 ESP Chahrazed, Alger, Algeria; 3 Medico-social center Bou-ismail, Alger, Algeria; 4 University Hospital, Amiens, France;

Date, time and location: 2018.05.26 15:30, Press Hall, 2F

Abstract

Purpose.
  • Warm fresh whole blood (wfWB), which addresses simultaneously all the elements of blood failure, has recently gained a revival of interest for remote damage control resuscitation of war casualties or for hemorrhagic shock post trauma. We aimed at assessing the safety and efficacy of wfWB in the surgery of aorta.

Material and Methods.

  • Observational study including all patients operated on by us for aortic surgery and who received wfWB transfusion. Before surgery the patient designed relative ABO compatible donors for whom a negative serology for blood transmissible infectious diseases was double checked. During surgery one bag of whole blood was collected from those donors and was transfused within 6 hours to the patient at the end of CPB after heparin reversal. Additive hemostatic medications included tranexamic acid but no surgical glue. Study end points were 24 hours blood loss and combined operative mortality/severe complications.
Results
  • We included 18 consecutive patients operated on under normothermia : simple aneurysm of the ascending aorta (5), aortic root replacement with mechanical composite grafts (7) or under moderate hypothermia: type A acute aortic dissection (4) and arch aneurysms (2). Patients received an average of 1.3 bags of wfWB (1-4). Mean blood loss measured at 24 hours postoperatively was 183 cc (120-550). Mean platelets account at 24 hours postoperatively was 220 000/mm3. No patients needed second sternotomy for bleeding or secondary tamponnade. Neither postoperative mortality nor severe complications were reported to donors or recipients.
Conclusion.
  • We report the first application of wfWB in aortic surgery. Found effective in military medicine and post-trauma hemorrhage resuscitation, wfWB also has the potential to treat surgery induced blood dyscrasia and might expand the feasibility of aortic surgery in countries where the chain of blood supply is under stress.

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