Prediction of transfusion therapy tactics for prophylaxis of early postoperative complications in coronary surgery

Abstract

The study focuses on the tactics of transfusion therapy during coronary artery bypass surgery with cardiopulmonary bypass in patients with left ventricular ejection fraction higher or lower than 40%. To predict the tactics of intraoperative transfusion therapy, hypoxic tests were preoperatively conducted in the main group of patients. A traditional approach to blood transfusion was applied in the control group of patients. The analysis of clinical and laboratory data, hemodynamics and oxygen balance, as well as follow-up data allowed to prove the possibility of decreasing allogenic blood use by 48.8% (p = 0,02). Based on the hypoxic test data, criteria for lowering the intraoperative trigger hemoglobin level down to 70 g/l, including the patients with a low left ventricular ejection fraction. It was shown that our tactics of trigger hemoglobin level calculation allows for reducing artificial lung ventilation time, frequency of gastrointestinal complications, multiple organ failure, as well as duration of stay at ICU.