ABSTRACT 79

BENEFIT OF THE BLOOD TRANSFUSION INDEX IN OPEN HEART SURGERY

Etsuro Suenaga, Hisao Suda, Yuji Katayama, Satoshi ohtsubo, Tsuyoshi Itoh
Department of Thoracic and Cardiovascular Surgery,
Saga Medical school, Saga, Japan

Background: In open heart surgery, a large amount of homologous transfusions may lead to prolonged patient recovery by causing systemic inflammatory response such as pulmonary dysfunction, renal dysfunction and brain edema. Prediction of the need for homologous blood transfusion in open heart surgery may improve costeffectiveness and postoperative management. Blood transfusion index, BTI (Preoperative hematocrit x Body weight) has been tested if it can predict the need for homologous blood transfusion.

Patient and methods: SEP.1996 until May.2000, 356 patients were underwent elective open heart operation. The patients were divided in two groups, who were underwent operation without blood homologous transfusions (N group), and who needed blood homologous transfusions (B group). Two groups were compared in age, sex, preoperative Ht., CPB time, the blood transfusion index (BTI) and postoperative clinical course.

Result: Two hundred fifty three patients (71.0%) did not required homologous blood transfusion. There were significant differences in sex and BT index. In male, BT index was 2446+40 in N group vs.2105+585 in B group. In female, BT index was 1867+349 in N group vs.1641+427 in B group.

Conclusion: BTI was useful preoperative parameter to predict the need for homologous transfusion. Homologous blood transfusion is significantly related to amount of postoperative bleeding and extubation time. BTI is representative of preoperative parameters such as age, sex, body weight, height, BSA and Ht.