Strategy for Conducting Cardiopulmonary Bypass to Reduce Blood Loss in Cardiac Surgery.

Objective:To optimize the completion phase of cardiopulmonary bypass (CPB) to reduce blood loss in cardiac surgery. Materials and Methods: The study included 62 patients who underwent surgery with CPB and were divided into two groups. In the main group (n=31), at the end of CPB, the entire volume of blood from all circuits of the CPB machine was returned to the patient's central vein. In the comparison group (n=31), the conventional method of residual blood return after CPB was used. Results: Intraoperative blood loss was significantly lower in the main group compared to the comparison group (500 [470-520] vs. 800 [760-830] mL, p=0.0001). Levels of creatinine, ALT, and amylase in the main group were higher than in the comparison group 24 hours postoperatively. At the end of surgery, the main group showed significantly higher cardiac output (3.1 [2.8-3.6] vs. 2.8 [2.6-3.1], p=0.018) and global ejection fraction (28 [22-31] vs. 22 [19-24], p=0.011) compared to the comparison group. In the comparison group, the global end-diastolic volume index significantly decreased relative to the baseline value (753 [665-900] vs. 647 [615-820], p=0.019). Conclusion: Complete blood reinfusion after CPB increases hemoglobin and hematocrit levels in the early postoperative period, reduces blood loss, and is associated with higher cardiac index and global ejection fraction after the main surgical stage.