Allogeneic Red Blood Cell Transfusion Is an Independent Risk Factor for the Development of Postoperative Bacterial Infection

Abstract

These data support the hypothesis that allogeneic red cell transfusion is an independent risk factor for the development of postoperative bacterial infection in patients undergoing colorectal surgery. This association provides further reason to minimise exposure to allogeneic transfusions in the perioperative setting.

Fatores preditivos de infecção em pacientes com fraturas expostas nos membros inferiores

“…Como persistisse esta afirmação por vários autores, incluímos este dado na pesquisa de nossos fatores preditivos de infecção e encontramos alta significância estatística na amostra estuda. Na verdade, analisando em conjunto os fatores preditivos detectados na nossa amostra, reavaliando as conseqüências da gravidade do trauma na microcirculação e os riscos de infecções bacterianas associados à transfusão de papa de hemáceas em pacientes submetidos à cirurgia de quadril e cirurgia geral, redimensionamos a importância desta variável como fator preditivo de infecção (3,4) .…”

“…But as this statement was constant in many papers, we decided to include it in our research about the predictive infection factors and we found a high statistical significance in the sample studied. Actually, by analyzing all the predictive factors found in our sample, and reevaluating the consequences of the severity of the trauma in the microcirculation and the bacterial risks of infection associated with the transfusion of red blood cells in patients that underwent a hip surgery and a general surgery, the importance of this variable as a predictive infection factor had to be reevaluated (3,4) . The type of accident that caused the fracture is frequently associated with the severity of the injury as well as to the severity of the patient.…”

Deleterious clinical effects of transfusion-associated immunomodulation: fact or fiction?

“…61 Until recently, observational studies reporting an association between allogeneic blood transfusion and postoperative infection did not adjust for the effects of severity of illness and/or risk factors for postoperative infection at specific sites. Some teams of investigators secured partial control for the effects of these variables by excluding UTIs from the definition of postoperative infection 69,71 ; by limiting the outcome variable to postoperative wound infection [72][73][74] ; or by adjusting for the effects of serum albumin, 75,76 insertion of a urinary catheter, 77,78 or presence of chronic systemic illness, 70 or diabetes mellitus. 79 However, adjustment for the effects of all these factors in combination has rarely been presented in the literature.…”

Blood conservation strategies to reduce the need for red blood cell transfusion in critically ill patients

“…4,10 Although the exact mechanism for the increased morbidity and mortality associated with blood transfusions is unknown, immunomodulation [11][12][13] and the red blood cell storage lesion (decreased ability of stored red blood cells to transport, release or deliver oxygen) are plausible explanations.…”