The Effect of Antegrade Pump Blood Reinfusion Via Crystalloid "Chase" Technique on Postoperative Transfusion Requirements in Adult Cardiac Surgery Patients: A Prospective Observational Study
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 130
- 试验地点
- 1
- 主要终点
- Postoperative Blood Transfusion Requirement
研究概览
简要总结
This prospective observational study aims to evaluate the effect of antegrade pump blood reinfusion using the crystalloid "chase" technique on postoperative transfusion requirements in adult patients undergoing cardiac surgery with cardiopulmonary bypass. At the end of cardiopulmonary bypass, blood remaining within the cardiopulmonary bypass circuit is reinfused antegradely through the arterial line using a crystalloid chase, without collection or storage. Blood remaining within the bypass circuit after surgery represents a valuable source of autologous blood, and its reinfusion may contribute to perioperative blood conservation strategies. Patients receiving antegrade pump blood reinfusion via the chase technique will be compared with those managed without reinfusion, without any intervention by the investigators. The primary outcome is postoperative blood transfusion requirement.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 18 to 80 years
- •Patients undergoing elective, isolated coronary artery bypass grafting surgery using cardiopulmonary bypass (on-pump).
排除标准
- •Emergency or Redo cardiac surgery
- •Concomitant cardiac procedures (e.g., valve repair/replacement or aortic surgery).
- •Planned or intraoperative conversion to off-pump coronary artery bypass grafting
- •Preoperative hematocrit <30% or known inherited/acquired bleeding disorders.
- •Preoperative left ventricular ejection fraction <30%.
- •Thrombocytopenia (e.g., platelet count <100×10³/µL) or abnormal coagulation tests.
- •Use of antiplatelet agents other than aspirin without appropriate discontinuation according to current guideline-recommended preoperative intervals.
- •Use of anticoagulant therapy without appropriate preoperative discontinuation according to current guideline recommendations.
- •Use of non-steroidal anti-inflammatory drugs (NSAIDs) without appropriate discontinuation prior to surgery.
- •Severe renal dysfunction (eGFR <30 mL/min/1.73 m² or dialysis) and/or severe hepatic dysfunction (Child-Pugh B-C or coagulopathy).
- •Active infection or systemic inflammatory/autoimmune disease.
- •Active malignancy requiring ongoing treatment
- •Refusal or inability to provide written informed consent.
研究组 & 干预措施
Antegrade Pump Blood Reinfusion (Chase Technique)
Adult patients undergoing cardiac surgery with cardiopulmonary bypass in whom antegrade pump blood reinfusion is performed at the end of bypass using the crystalloid chase technique, as part of routine clinical practice.
干预措施: Antegrade Pump Blood Reinfusion (Procedure)
No Pump Blood Reinfusion
Adult patients undergoing cardiac surgery with cardiopulmonary bypass in whom antegrade pump blood reinfusion is not performed at the end of bypass, and standard clinical management is applied.
干预措施: No Anterograde Pump Blood Reinfusion (Other)
结局指标
主要结局
Postoperative Blood Transfusion Requirement
时间窗: From the end of surgery to 24 hours postoperatively
Incidence of allogeneic blood transfusion within the first 24 hours after surgery.
次要结局
- Postoperative Drainage Volume(From the end of surgery to 24 hours postoperatively)
- Number of Transfused Blood Units(From the end of surgery to 24 hours postoperatively)
研究者
Zeynep Yasemin Tavşanoğlu
Principal Investigator, Medical Doctor
Kocaeli City Hospital