Effect of the fresh whole blood transfusion on perioperative bleeding in adult patients undergoing emergency coronary artery bypass grafting surgery: a randomized study

Abstract

Objective The present study aimed to assess the hemostatic effects of fresh whole blood (FWB) transfusion on bleeding and blood product transfusion in patients on clopidogrel undergoing emergency coronary artery bypass grafting surgery (CABG). Design A randomized study was conducted. Setting The study was conducted at a cardiac center. Patients and methods The study included 124 patients undergoing CABG surgery. The patients were divided into two groups: FWB group patients received two to six units of FWB after weaning off cardiopulmonary bypass and in the cardiac surgery ICU. Control group patients received blood products (packed red blood cells, platelets, fresh frozen plasma, or cryoprecipitate) after weaning off cardiopulmonary bypass and after surgery in cardiac surgery ICU. Total number of the transfused FWB, platelets, packed red blood cell, fresh frozen plasma, and cryoprecipitate (intraoperative and postoperative transfusion), bleeding time, and platelet aggregation function were measured. Moreover, the thorax closure time and amount of blood losses, re-exploration, pulmonary edema, and postoperative mechanical ventilation were monitored. Results FWB significantly decreased the blood loss and blood product transfusion compared with the control group (P=0.001 and 0.001, respectively). The bleeding time and platelet aggregation function were better in the FWB group compared with the control group (P=0.020 and 0.034, respectively). Moreover, the thorax closure time, cardiac tamponade, re-exploration, pulmonary edema, and postoperative mechanical ventilation decreased significantly in the FWB group compared with the control group (P Conclusion FWB decreased the blood loss, blood product transfusion, cardiac tamponade, and re-exploration in patients on preoperative clopidogrel undergoing emergency CABG.