TO STUDY RETROGRADE AUTOLOGUS PRIMING (RAP) AS AN IMPORTANT BLOOD CONSERVATION MODALITY AND ITS ROLE IN POST OPERATIVE OUTCOME - A STUDY OF 200 CASES IN MADRAS MEDICAL COLLEGE, CHENNAI.

Dr P Amirtharaj

Volume : VII, Issue : XI, November - 2018

TO STUDY RETROGRADE AUTOLOGUS PRIMING (RAP) AS AN IMPORTANT BLOOD CONSERVATION MODALITY AND ITS ROLE IN POST OPERATIVE OUTCOME - A STUDY OF 200 CASES IN MADRAS MEDICAL COLLEGE, CHENNAI.

Dr P Amirtharaj

Abstract :

AIMS AND OBJECTIVES :

To study the effect of retrograde autologous priming techniques on transfusion requirements and outcome in CABG patients.

The effect on peri-operative transfusion requirements.
The effect on post-operative morbidity.
The effect on duration of post operative stay.

MATERIALS AND METHODS :

We analysed the patient details retrospectively using the charts as well as our clinical clinical workstation. Categorical data were expressed as frequency and percentage. Categorical data were expressed as frequency and percentage. Continuous variable expressed as mean � standard deviation. Significant differences between proportions determined by Chi-squared analysis or Fischer‘s exact test. All analysis were carried out using Statistical Package for Social Service version 16(SPSS Inc.,Chicago, IL, USA). Probablity values p<0.05 were considered significant.

RESULTS:

We had a total of 200 patients in our series from 2014-15. Coronary artery disease is more common in males 83% of our study group. Commonly seen in Diabetics(60%), hypertensives(62%) and smokers(30%), their respective percentages in the study population. Analysing Retrograde autologus priming as a blood conservation modality we were able to derive at a reduction in hemodilution, transfusion rates, creatnine and lactate levels, period of stay but were not able to exhibit statistical significance. The factors like intra operative hemodilution(p=0.039) and transfusion(p=0.050). Post operative creatnine levels(p=0.026) and Stay in the ICU(p=0.014) were significant.

CONCLUSION:

We were able to establish Retrograde Autologus Priming as one of the blood conservation modalities. As in other literature, our study also suggests that Retrograde Autologus Priming of cardiopulmonary bypass circuit as an effective blood conservation modality. There is a significant reduction in the total transfusion rates of patients in the Retrograde Autologus Priming group in the overall study. Though only the intra op transfusion rates and post operative critical care stay were deemed statistically significant, in this retrograde study, It is promising to note and could get more gratifying results if there could be a prospective study with strict transfusion triggers