Coronary Artery Disease
Conditions
Brief summary
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.
Interventions
PROCEDUREAntegrade Pump Blood Reinfusion
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.
OTHERNo Anterograde Pump Blood Reinfusion
Adult patients undergoing cardiac surgery with cardiopulmonary bypass in whom anterograde pump blood reinfusion is not performed at the end of bypass. Standard institutional clinical management is applied.
Sponsors
Kocaeli City Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age 18 to 80 years * Patients undergoing elective, isolated coronary artery bypass grafting surgery using cardiopulmonary bypass (on-pump).
Exclusion criteria
* 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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Blood Transfusion Requirement | From the end of surgery to 24 hours postoperatively | Incidence of allogeneic blood transfusion within the first 24 hours after surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Drainage Volume | From the end of surgery to 24 hours postoperatively | Total postoperative chest drainage volume within the first 24 hours after surgery. |
| Number of Transfused Blood Units | From the end of surgery to 24 hours postoperatively | Total number of allogeneic blood transfusion units administered within the first 24 hours after surgery. |
Countries
Turkey (Türkiye)
Contacts
CONTACTYılmaz
PRINCIPAL_INVESTIGATORZeynep Yasemin Tavsanoglu, MD
Kocaeli City Hospital, Department of Anesthesiology and Reanimation
Outcome results
None listed