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Anoar Zacharias
Thomas A. Schwann
Christopher J. Riordan
Samuel J. Durham
Aamir Shah
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J Thorac Cardiovasc Surg 2004;127:1227-1228
© 2004 The American Association for Thoracic Surgery

Letter to the editor

Reply to the Editor

Robert H. Habib, PhDa,b, Anoar Zacharias, MDa,b, Thomas A. Schwann, MDa,b, Christopher J. Riordan, MDa,b, Samuel J. Durham, MDa,b, Aamir Shah, MDa,b

a Cardiovascular Surgery, Saint Vincent Mercy Medical Center, Saint Luke's Hospital, Toledo, Ohio, USA
b Medical College of Ohio, Toledo, OH 43608, USA

The first 20% of the full text of this article appears below.

We thank Dr Shuhaiber for his interest in our recent article in the Journal.1 We are encouraged that he concurs with us that low extremes of hematocrit during cardiopulmonary bypass (CPB) should be avoided and that the strong associations we reported between excessive hemodilutional anemia during bypass and adverse patient outcomes argue for a prospective study. He also requested methodologic clarifications and presented several comments that are worthy of addressing.

Our 5000-patient CPB retrospective series1 (1994–2000) reflects a population in whom asanguinous rather than blood prime fluid was used. In a very small fraction of patients (anemic patients with low red blood cell volume), blood may have been added to the prime at the onset of CPB. These are included as intraoperative transfusions. Aprotinin was used relatively infrequently (<7%), and we believe it had little bearing, if any, on the reported findings. Standard intraoperative cell-saving methods were used routinely, and saved cells were returned to patients during or immediately after CPB. Hemoconcentration during . . . [Full Text of this Article]


Related Article

Intraoperative hematocrit and cardiopulmonary bypass
Jeffrey H. Shuhaiber
J. Thorac. Cardiovasc. Surg. 2004 127: 1226-1227. [Extract] [Full Text] [PDF]





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