Preditores de transfusão de concentrado de hemácias em cirurgia de revascularização miocárdica

Sá, Michel Pompeu Barros de Oliveira; Soares, Evelyn Figueira; Santos, Cecília Andrade; Figueiredo, Omar Jacobina; Lima, Renato Oliveira Albuquerque; Rueda, Fábio Gonçalves de; Escobar, Rodrigo; Soares, Alexandre Magno Macário Nunes; Lima, Ricardo de Carvalho

doi:10.5935/1678-9741.20110044

Cited by 2 publications

(2 citation statements)

References 43 publications

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“…In a prospective, randomized and controlled trial, it has become evident the increased mortality risk associated to the transfusions of 1-2, 3-4, 5-6 and > 6 units of packed red blood cells after cardiac surgery [ 11 ] . In the literature, there are other studies [ 15 , 20 ] , which have also shown adverse clinical outcomes by the amount of PRBCs associated effect. Our study has shown the isolated adverse effect of every allogeneic PRBCs unit transfused in the patient's population after one year of CABG surgery.…”

Section: Discussionmentioning

confidence: 99%

“…In another study it has become evident that a more conservative blood transfusion approach, in cardiac surgery with CPB, it does not alter the mortality rate among the groups of restrictive strategy (hematocrit ≥ 24%) and liberal strategy (hematocrit ≥ 30%) [ 11 ] . It is already known that patients with hematocrit below 40%, and need for cardiopulmonary bypass and multiple bypasses, have a greater likelihood to use blood in CABG surgery, therefore, to identify, treat and/or prevent these conditions will result in less use of blood products transfusion [ 20 ] . Souza & Braile [ 24 ] demonstrated that a hemoconcentration during the CPB associated to a reduced water balance, is also able to decrease the use of blood and plasma in cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

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Mortality risk is dose-dependent on the number of packed red blood cell transfused after coronary artery bypass graft

Santos¹,

Sousa²,

Piotto³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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IntroductionTransfusions of one or more packed red blood cells is a widely strategy used in cardiac surgery, even after several evidences of increased morbidity and mortality. The world's blood shortage is also already evident. ObjectiveTo assess whether the risk of mortality is dose-de>pendent on the number of packed red blood cells transfused after coronary artery bypass graft. MethodsBetween June 2009 and July 2010, were analyzed 3010 patients: transfused and non-transfused. Transfused patients were divided into six groups according to the number of packed red blood cells received: one, two, three, four, five, six or more units, then we assess the mortality risk in each group after a year of coronary artery bypass graft. To calculate the odds ratio was used the multivariate logistic regression model. ResultsThe increasing number of allogeneic packed red blood cells transfused results in an increasing risk of mortality, highlighting a dose-dependent relation. The odds ratio values increase with the increased number of packed red blood cells transfused. The death's gross odds ratio was 1.42 (P=0.165), 1.94 (P=0.005), 4.17; 4.22, 8.70, 33.33 (P<0.001) and the adjusted death's odds ratio was 1.22 (P=0.43), 1.52 (P=0.08); 2.85; 2.86; 4.91 and 17.61 (P<0.001), as they received one, two, three, four, five, six or more packed red blood cells, respectively. ConclusionThe mortality risk is directly proportional to the number of packed red blood cells transfused in coronary artery bypass graft. The greater the amount of allogeneic blood transfused the greater the risk of mortality. The current transfusion practice needs to be reevaluated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mortality risk is dose-dependent on the number of packed red blood cell transfused after coronary artery bypass graft

Santos¹,

Sousa²,

Piotto³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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Análise dos resultados imediatos da cirurgia de revascularização do miocárdio com e sem circulação extracorpórea

Cantero¹,

Almeida²,

Galhardo³

2011

Rev Bras Cir Cardiovasc

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Objective: The objective of this study is to compare the immediate results of patients undergoing on-pump versus off-pump coronary artery bypass graft (CABG) surgery.Methods: From January 2007 to January 2009, 177 patients underwent CABG. Of these, 92 underwent off-pump CABG and 85 on-pump CABG. We evaluated the demographics, preoperative risk factors, preoperative functional class, and risk assessment by the EuroSCORE. A comparison between both groups regarding the postoperative evolution was carried out as well.Results: The mean number of grafts per patient was 2.48 ± 0.43 in the off-pump group versus 2.90 ± 0.59 in the onpump group. In the off-pump group, 97.8% of patients received an internal thoracic artery graft, while in the onpump group, the percentage was 94.1% (P = 0.03). The rate of complete revascularization was similar in both groups. In the off-pump group, the circumflex artery (circumflex branch of the left coronary artery) was revascularized in 48.9% of the patients versus 68.2% of the patients in the onpump group (P = 0.01). Hospital mortality was 4.3% for offpump CABG and 4.7% for on-pump CABG (P = 0.92). The off-pump group had fewer complications in relation to perioperative myocardial infarction (P = 0.02) and use of intra-aortic balloon pump (P = 0.01).Conclusion: The off-pump CABG is a safe procedure with hospital mortality similar to that observed in on-pump CABG, with lower rates of complications and less need for intra-aortic balloon. Rev Bras Cir Cardiovasc 2012;27(1):38-44 Descriptors

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Preditores de transfusão de concentrado de hemácias em cirurgia de revascularização miocárdica

Cited by 2 publications

References 43 publications

Mortality risk is dose-dependent on the number of packed red blood cell transfused after coronary artery bypass graft

Mortality risk is dose-dependent on the number of packed red blood cell transfused after coronary artery bypass graft

Análise dos resultados imediatos da cirurgia de revascularização do miocárdio com e sem circulação extracorpórea

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