RecruitingNCT07420582

Antegrade Autologous Blood Reinfusion After CPB

The Effect of Antegrade Pump Blood Reinfusion Via Crystalloid "Chase" Technique on Postoperative Transfusion Requirements in Adult Cardiac Surgery Patients: A Prospective Observational Study

Sponsor

Kocaeli City Hospital

Enrollment

130 participants

Start Date

Feb 23, 2026

Study Type

OBSERVATIONAL

Conditions

Coronary Artery Disease

Summary

This prospective observational study aims to evaluate the effect of antegrade pump blood reinfusion using the crystalloid "chase" technique on postoperative transfusion requirements in adult patients undergoing cardiac surgery with cardiopulmonary bypass. At the end of cardiopulmonary bypass, blood remaining within the cardiopulmonary bypass circuit is reinfused antegradely through the arterial line using a crystalloid chase, without collection or storage. Blood remaining within the bypass circuit after surgery represents a valuable source of autologous blood, and its reinfusion may contribute to perioperative blood conservation strategies. Patients receiving antegrade pump blood reinfusion via the chase technique will be compared with those managed without reinfusion, without any intervention by the investigators. The primary outcome is postoperative blood transfusion requirement.

Eligibility

Min Age: 18 YearsMax Age: 80 Years

Inclusion Criteria2

Age 18 to 80 years
Patients undergoing elective, isolated coronary artery bypass grafting surgery using cardiopulmonary bypass (on-pump).

Exclusion Criteria13

Emergency or Redo cardiac surgery
Concomitant cardiac procedures (e.g., valve repair/replacement or aortic surgery).
Planned or intraoperative conversion to off-pump coronary artery bypass grafting
Preoperative hematocrit <30% or known inherited/acquired bleeding disorders.
Preoperative left ventricular ejection fraction <30%.
Thrombocytopenia (e.g., platelet count <100×10³/µL) or abnormal coagulation tests.
Use of antiplatelet agents other than aspirin without appropriate discontinuation according to current guideline-recommended preoperative intervals.
Use of anticoagulant therapy without appropriate preoperative discontinuation according to current guideline recommendations.
Use of non-steroidal anti-inflammatory drugs (NSAIDs) without appropriate discontinuation prior to surgery.
Severe renal dysfunction (eGFR <30 mL/min/1.73 m² or dialysis) and/or severe hepatic dysfunction (Child-Pugh B-C or coagulopathy).
Active infection or systemic inflammatory/autoimmune disease.
Active malignancy requiring ongoing treatment
Refusal or inability to provide written informed consent.

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Interventions

PROCEDUREAntegrade Pump Blood Reinfusion

Adult patients undergoing cardiac surgery with cardiopulmonary bypass in whom antegrade pump blood reinfusion is performed at the end of bypass using the crystalloid chase technique, as part of routine clinical practice.

OTHERNo Anterograde Pump Blood Reinfusion

Adult patients undergoing cardiac surgery with cardiopulmonary bypass in whom anterograde pump blood reinfusion is not performed at the end of bypass. Standard institutional clinical management is applied.