Open Heart Surgery Without Blood Transfusion

DEVELOPMENT of the pump oxygenator for open heart surgery and clinical progress over the past decade now allow successful surgical correction of most congenital and acquired cardiac lesions. For many years, however, procurement of large quantities of blood necessary for priming most pump oxygenators used for these operations taxed blood banking facilities throughout the country and limited use of cardiopulmonary bypass in emergency situations. Demonstration of the adverse effects produced by such a pool of homologous blood further emphasized the advantages of eliminating this blood prime.¹

The feasibility of priming extracorporeal circuits with a variety of nonblood solutions soon was established,^2-5 and in April 1962, we adopted a technique of open heart surgery using disposable plastic oxygenators primed only with 5% dextrose in distilled water.⁶ With this technique extracardiac blood loss usually was replaced with banked acid-citrate-dextrose blood as during any major operative procedure. However, our policy