Effects of autologous blood recovery on blood component and coagulation function during cardiopulmonary bypass in infants

doi:10.3969/j.issn.1672-5301.2017.03.005

Abstract：Objective To observe the effects of autologous blood recovery infusion on blood components and blood coagulation in infants during cardiopulmonary bypass. Methods 80 patients were randomly divided into observation group and control group, each group included 40 cases. Blood recovery machine was used in observation group us,all intraoperative and extracorporeal blood in circulation machine was recovered,and infused into the children within 6 hours after surgery. The control group did not use blood recovery machine,intraoperative and extracorporeal residual blood was wasted. The gender,age,body weight,intraoperative circulation time,aorta block time were documented. Hemoglobin(Hb),hematocrit(Hct),platelet(PLT)were measured before operation, 15 min,24 h and 5 days after operation. Prothrombin time (PT),international normalized ratio (INR),activated partial thromboplastin time(APTT),fibrinogen(FIB),thrombin time(TT),D-D dimmer,fibrinogen degradation product (FDP)were measured before operation,15 min,24 h and 72 h after operation. The drainage volume 24 h after operation, the rate of perioperative use of allogeneic blood, the amount of red blood cells using perioperatively, the rate of postoperative prothrombin complex (PCC) utilization were also measured. Results There were no statistically significant differences in sex,age,body weight,intraoperative circulation time and aorta block time between the two groups (P>0.05). There were no significant differences in Hb,Hct,PLT,PT,INR, APTT,FIB,TT,D-D and FDP in the two groups before operation(P>0.05). There were significant differences in PT,INR,APTT,TT,DD and FDP in the two groups at each time point 15 min after operation compared with before operation (P<0.05). There was no significant difference in INR,APTT,FIB,TT,DD and FDP between two groups(P>0.05). There was significant difference 15 min after operation between Hb and Hct in two groups(P<0.05). There was no significant difference in Hb,Hct and PLT in the two groups after operation for 24 h and 5 days compared with before operation (P>0.05),the difference between groups was not statistically significant (P>0.05). There was significant difference between the two groups (P<0.05)of the rate of using allogeneic blood and the amount of red blood cells using perioperatively. There was no significant difference between the two groups in the postoperative 24 h drainage volume and the PCC use rate (P>0.05). Conclusion There is no significant difference in blood coagulation function of autologous blood recovery in children after cardiopulmonary bypass. The use of autologous blood recovery can significantly reduce,and does not increase the complications,this can be actively applied in pediatric cardiac surgery.