Analysis of perioperative blood transfusion in patients with acute Stanford type A aortic dissection surgery
10.13303/j.cjbt.issn.1004549x.2024.09.009
- VernacularTitle:急性Stanford A型主动脉夹层患者围术期用血情况分析
- Author:
Shaoqiang ZHANG
1
;
Qing LIU
2
;
Zifan MENG
1
;
Shuzhen LIU
1
Author Information
1. Department of Blood Transfusion, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
2. Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
- Publication Type:Journal Article
- Keywords:
aortic dissection;
cardiopulmonary bypass;
blood transfusion;
coagulation function monitoring
- From:
Chinese Journal of Blood Transfusion
2024;37(9):1018-1022
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To retrospectively analyze the blood transfusion of 322 patients with Stanford type A aortic coarctation in our hospital, and to explore the influencing factors of perioperative blood transfusion in patients and evaluate the effect. 【Methods】 The patients with Stanford A type aortic coarctation who underwent surgical treatment in our hospital from October 2020 to October 2023 were selected to analyze the differences in blood transfusion and the monitoring of blood routine and coagulation function between different surgical modalities, and to evaluate the influencing factors of massive blood transfusion. 【Results】 The intraoperative allogeneic red blood cell transfusion rate was 63.98% and the perioperative allogeneic red blood cell transfusion rate was 85.71% in patients with Stanford type A aortic coarctation. The intraoperative red blood cell, plasma, cryoprecipitates and platelet transfusion volumes for the Bentall procedure were (3.75±3.81) U, (608.13±314.77) mL, (15.25±8.39) U and (1.53±0.78) therapeutic doses, respectively, and had no difference compared with those for Sun′s procedure with the transfusion volume of (3.13±4.04) U, (707.61± 461.21) mL, (15.79±6.59) U and (1.54±0.64) therapeutic doses and those for Bentall&Sun’s procedure with the transfusion volume of (3.04±4.41) U, (813.48±582.02) mL, (18.39±6.43) U and (1.76±0.58) therapeutic doses(P>0.05). Preoperative hemoglobin levels were significantly lower in patients treated with Bentall procedure (127.75±23.17) g/L and in patients treated with Sun′s procedure (126.07±16.14) g/L than in patients treated with Bentall & Sun′s procedure(133.17±18.12) g/L(P<0.05). Postoperative hemoglobin, APTT and platelet counts were not statistically different between groups(P>0.05). Perioperative erythrocyte massive infusion accounted for 53.42%. The length of hospital days(days) in the massive transfusion group (23.83±9.74) was significantly higher than that in the conventional transfusion group (31.71±22.98), and the mortality rate in the massive infusion group 34.88% was significantly higher than that in the conventional transfusion group (5.33%)(P<0.05), and the hemoglobin level (g/L) at discharge in the massive infusion group(95.65±11.58)was lower than that in the conventional transfusion group(101.93±15.77)(P<0.05). 【Conclusion】 Blood transfusion is necessary to ensure the perioperative treatment of patients with acute Stanford type A aortic coarctation. Massive transfusion of red blood cells is accompanied by an increase in mortality rate and prolonged hospital stay. The test of coagulation function is helpful in guiding the use of blood components, and individualized restrictive transfusion strategy can reduce unnecessary blood transfusion and is conductive to patient safety.
