Anesthesia in open heart surgery without blood transfusion. Report I: Several anesthetic problems
Ohe, Y.; Iwabuchi, K.; Sato, H.
Masui. Japanese Journal of Anesthesiology 34(7): 939-944
1985
ISSN/ISBN: 0021-4892 PMID: 3932706 Document Number: 243234
Several anesthetic problems of open heart surgery without blood transfusion are discussed comparing 15 radical repairs of atrial septal defect with blood transfusion (Group-BT) and 15 surgeries without blood transfusion (Group-NBT). The body weights of these cases are more than 20 kg. The value of hematocrit during and soon after cardiopulmonary bypass was lower in Group-NBT, but did not show any statistical difference in 2 groups at the end of surgery. Blood gas and electrolyte analysis showed lower PaO2 [arterial O2 pressure], more metabolic acidosis and lower Na+ in Group-NBT, but PaCO2 [arterial CO2 pressure] and K+ remained the same in 2 groups. The blood loss was measured twice in Group-BT in spite of the same value in active coagulation time. The urine output and infusion volume were significantly higher in Group-BT (P < 0.001). A tendency for lower PaO2 and more metabolic acidosis due to the decrease of hematocrit were observed in Group-NBT. So to perform successful open heart surgery without blood transfusion, it is necessary to have good cardiac reserve to counteract the temporary increase of circulatory volume, and have good renal function to excrete the excess volume in an early phase after surgery.