Targeted Fresh Autologous Whole Blood Transfusion After Cardiopulmonary Bypass: a Prospective Randomized Controlled Trial.
University of Colorado, Denver
Summary
Autologous blood transfused at the end of cardiopulmonary bypass will reduce total blood loss 24 hours after surgery and improve mitochondrial oxygen delivery measured by plasma succinate levels. The study design is a prospective randomized interventional trial of transfusion of fresh autologous whole blood versus standard of care expectant management of bleeding during elective cardiac surgery.
Description
Cardiac surgery carries a significant risk of bleeding requiring transfusion of stored blood products and blood transfusion associated with cardiac surgery consumes 20% of the blood supply worldwide. Although transfusion may be life-saving, significant risks of complications such as lung injury or even an increase in mortality are associated with transfusion. Decreasing transfusion requirements during cardiac surgery has the potential to reduce the rate of complications, improve patient outcomes, and reduce cost resulting in increased value for both the patient and the health system as a whole…
Eligibility
- Age range
- 18–90 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Adult subjects aged 18 to 90 2. Able to provide informed consent 3. Willing to accept autologous or allogenic blood transfusion 4. Scheduled for elective cardiac surgery with cardiopulmonary bypass Exclusion Criteria: 1. Pre-operative administration of allogenic blood bank products in the previous 3 months 2. Hemodynamically unstable defined as a systolic blood pressure less than 90 mmHg with a heart rate greater 100 or requiring intravenous vasopressor medications 3. Significant active infection or sepsis defined by positive blood culture or positive wound culture 4.…
Interventions
- OtherFresh Autologous whole Blood
Subjects randomized this arm will receive fresh autologous whole blood
- OtherStandard of Care Expectant management of bleeding
the control group that will receive the standard of care expectant management of bleeding and transfusion of allogenic banked blood products
Location
- University of Colorado HospitalAurora, Colorado