OPEN HEART SURGERY WITHOUT BLOOD TRANSFUSION UNDER SURFACE INDUCED PROFOUND HYPOTHERMIA

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  • 単純超低体温麻酔下無輸血開心術
  • タンジュン チョウテイタイオン マスイ カ ムユケツカイシンジュツ

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Abstract

With a view to save banked blood and to prevent post-transfusion hepatitis, open heart oper-ations were performed without blood transfusion in 15 patients who had congenital heart diseases using a technique of surface induced profound hypothermia during the period from April 1972 to March 1973. Congenital heart diseases in 15 patients were VSD (9 patients), ASD (2), PS (2), and VSD with PS (2). The average age was 7.5 years, ranging 3 to 18 years.<br>From the above experiences, following results were obtained:<br>1) Open heart operations were successfully performed without blood transfusion in all of the 15 patients.<br>2) Blood loss during the surgery was 13.7ml/kg in average, ranging 7 to 28ml/kg of body weight, which was replaced with twice amount of Saviosol (3% Dextran 40 in RL-8 solution) instead of homologous blood.<br>3) Red blood cell counts and hematocrit showed approximately 30% decrease in maximum on the third postoperative day, and recovered to preoperative value 4 to 6 weeks after surgery.<br>4) None of these 15 patients developed post-transfusion hepatitis during follow up period for more than 10 months.<br>5) Usually, a tendency of hypotension due to low blood viscosity caused by hemodilution was observed after resuscitation, and Isoproterenol deteriorated the hypotensive state.<br>Isoproterenol should be used carefully during and immediately after resuscitation.<br>We belive that our experience demonstrates the feasibility of open heart surgery without blood transfusion especially in infants and children using a technique of surface induced profound hypothermia.

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