Allogenic Blood Transfusion Does Not Predispose to Infection After Cardiac Surgery

Ali, Ziad A.; Lim, Eric; Motallebzadeh, Reza; Ali, Ayyaz; Callaghan, Chris; Gerrard, Caroline; Vuylsteke, Alain; Foweraker, Juliet; Tsui, Steven

doi:10.1016/j.athoracsur.2004.05.020

Cited by 30 publications

(23 citation statements)

References 33 publications

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“…Ali et al prospectively evaluated 232 consecutive cardiac patients for UTI and blood product usage [20]. They found no association between transfusions and incidence of UTI.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Urinary Tract Infections in Cardiac Surgical Patients

Gillen

Isbell

Michaels

et al. 2015

Surgical Infections

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Background: Risk factors for catheter-associated urinary tract infections (CAUTIs) in patients undergoing noncardiac surgical procedures have been well documented. However, the variables associated with CAUTIs in the cardiac surgical population have not been clearly defined. Therefore, the purpose of this study was to investigate risk factors associated with CAUTIs in patients undergoing cardiac procedures. Methods: All patients undergoing cardiac surgery at a single institution from 2006 through 2012 (4,883 patients) were reviewed. Patients with U.S. Centers for Disease Control (CDC) criteria for CAUTI were identified from the hospital's Quality Assessment database. Pre-operative, operative, and post-operative patient factors were evaluated. Univariate and multivariable analyses were used to identify significant correlations between perioperative characteristics and CAUTIs. Results: There were 55 (1.1%) documented CAUTIs in the study population. On univariate analysis, older age, female gender, diabetes mellitus, cardiogenic shock, urgent or emergent operation, packed red blood cell (PRBC) units transfused, and intensive care unit length of stay (ICU LOS) were all significantly associated with CAUTI [p < 0.05]. On multivariable logistic regression, older age, female gender, diabetes mellitus, and ICU LOS remained significantly associated with CAUTI. Additionally, there was a significant association between CAUTI and 30-d mortality on univariate analysis. However, when controlling for common predictors of operative mortality on multivariable analysis, CAUTI was no longer associated with mortality. Conclusions: There are several identifiable risk factors for CAUTI in patients undergoing cardiac procedures. CAUTI is not independently associated with increased mortality, but it does serve as a marker of sicker patients more likely to die from other comorbidities or complications. Therefore, awareness of the high-risk nature of these patients should lead to increased diligence and may help to improve peri-operative outcomes. Recognizing patients at high risk for CAUTI may lead to improved measures to decrease CAUTI rates within this population.

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“…Ali et al prospectively evaluated 232 consecutive cardiac patients for UTI and blood product usage [20]. They found no association between transfusions and incidence of UTI.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Urinary Tract Infections in Cardiac Surgical Patients

Gillen

Isbell

Michaels

et al. 2015

Surgical Infections

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“…A number of observational studies link allogeneic red blood cell (RBC) transfusion in cardiac surgery, including coronary artery bypass grafting (CABG), with increased morbidity and mortality [1,2], although not all studies have been able to confirm this association [3]. A few studies have examined the role of the storage time of allogeneic RBC before transfusion, and the results indicate that storage time may be an important determinant of transfusionrelated postoperative outcome, including severe postoperative infections [4,5], which have huge economic implications in terms of increased resource use during a prolonged hospital stay [6].…”

Section: Introductionmentioning

confidence: 99%

Storage time of allogeneic red blood cells is associated with risk of severe postoperative infection after coronary artery bypass grafting☆

Andreasen

Dethlefsen

Modrau

et al. 2011

European Journal of Cardio-Thoracic Surgery

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“…41 Although these studies imply that the transfusion of blood products increases the risk of infection, some studies have not noted an increased risk, 42 and others have argued that the effect of transfusion is minor. 37 Nevertheless, the risk of infection with transfusion can be decreased using autologous blood donation 37 versus allogenic blood.…”

Section: Blood Transfusion and The Risk Of Infectionmentioning

confidence: 99%

The Anesthesiologist's Role in the Prevention of Surgical Site Infections

Mauermann

Nemergut²

2006

Anesthesiology

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This article has been selected for the Anesthesiology CME Program. After reading the article, go to http:// www.asahq.org/journal-cme to take the test and apply for Category 1 credit. Complete instructions may be found in the CME section at the back of this issue.SURGICAL site infections (SSIs) continue to be a substantial source of morbidity and mortality in the surgical patient population. They are the second most common cause of nosocomial infection after urinary tract infections and account for approximately 17% of all hospital-acquired infections. 1 These infections lead to longer hospital and intensive care unit stays, lead to substantially increased mortality, and contribute significantly to healthcare costs. 2 In a 1999 series of cardiac surgery patients, each deep sternal wound infection added an average of $26,400 in hospital charges and increased the average duration of stay by 16 days. 3 The incidence of SSI varies for each operative procedure, each surgeon, and each hospital. In addition, each patient presents with his or her own unique risk profile for the development of a SSI. Although sterile surgical technique is extremely important to the prevention of SSIs, there is increasing evidence that anesthesiologists play a prominent yet under appreciated role in the prevention of SSIs. While infections typically present several days postoperatively, the first few hours after bacterial contamination are the critical window for the establishment of infection. 4,5 Therefore, decreasing SSIs hinges on the optimization of perioperative conditions, many of which are controlled by anesthesiologists.In this review, we will discuss the literature surrounding six perioperative factors over which anesthesiologists have at least partial control and how these factors may influence the risk of postoperative surgical site infection. Although we acknowledge that many anesthesiologists care for patients in the intensive care unit, we limit our discussion here to the immediate perioperative period. HypothermiaMild perioperative hypothermia (core body temperature 34°-36°C) is commonly observed in surgical patients. The complications of mild perioperative hypothermia have been studied extensively and include increased duration of hospitalization, 5 increased intraoperative blood loss and transfusion requirements, increased adverse cardiac events, and an increase in patient thermal discomfort in the recovery room. 6 The effects of mild hypothermia on SSI have also been studied.A series of 200 patients undergoing colorectal surgery were randomized to a hypothermic group (34.4°Ϯ 0.4°C) or a normothermic group (37°Ϯ 0.3°C) and followed for 2 weeks postoperatively. 5 The authors had planned to enroll 400 patients; however, the trial was stopped early because of a statistically significant difference in infection between the two groups. The incidence of SSI was 5.8% in the normothermic group and 18.8% in the hypothermic group. The patients who developed SSIs required hospital stays nearly 1 week longer than those who did not d...

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Allogenic Blood Transfusion Does Not Predispose to Infection After Cardiac Surgery

Cited by 30 publications

References 33 publications

Risk Factors for Urinary Tract Infections in Cardiac Surgical Patients

Risk Factors for Urinary Tract Infections in Cardiac Surgical Patients

Storage time of allogeneic red blood cells is associated with risk of severe postoperative infection after coronary artery bypass grafting☆

The Anesthesiologist's Role in the Prevention of Surgical Site Infections

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