Multimodality blood conservation program: toward an experience of coronary artery graft surgery without blood transfusion

Blood transfusion rate for coronary artery bypass grafting (CABG) accounts for more than 10% of all blood consumption. Studies have showed that combination of blood conservation methodstogether with the multimodality programs can reduce blood transfusion during the cardiac surgery. The aim of this study was to perform an audit of blood transfusion, determine the predictors of transfusion in CABG operation, and compare the predicted and injeced rate of blood transfusion as a method of quality assurance. In this prospective observational study, 105 consecutive patients at Jamaran Heart Hospital from September 2012 to January 2013 were included. They were undergoing isolated, primary CABG by a single surgical team. The team were following a multimodality blood conservation strategy The predicted and injected blood rates were 24.1% and 13.3%, respectively. (OR = 0.48, CI = 0.26-1.4). Only 2% of patients required 2 units of packed cell and nobody received more than 2 units of blood. Low patient weight (p = 0.010) and female gender (p = 0.032) were determined as two significant predictors of blood consumption. Multimodality blood conservation program can reduce blood transfusion in the CABG operation. Thus, in the current era open heart surgery without blood transfusion is possible.