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                     <i>Variability in Transfusion Practice for Coronary Artery Bypass Surgery Persists Despite National Consensus Guidelines</i> </b>

Stover, E P; Siegel, Lawrence C.; Parks, Reg; Levin, Jack; Body, Simon C.; Maddi, Rosemarie; D’Ambra, Michael N.; Mangano, Dennis T.; Spiess, Bruce D.

doi:10.1097/00000542-199802000-00009

Cited by 381 publications

(68 citation statements)

References 8 publications

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“…Transfusion rates during CABG vary between 0 and 100% [1,2,6,22]. Major benefit of prophylactic TA may not be found in institutions with low transfusion rates.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic tranexamic acid in elective, primary coronary artery bypass surgery using cardiopulmonary bypass

Andreasen

Nielsen

2004

European Journal of Cardio-Thoracic Surgery

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“…Transfusion rates during CABG vary between 0 and 100% [1,2,6,22]. Major benefit of prophylactic TA may not be found in institutions with low transfusion rates.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic tranexamic acid in elective, primary coronary artery bypass surgery using cardiopulmonary bypass

Andreasen

Nielsen

2004

European Journal of Cardio-Thoracic Surgery

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“…A recent multi-institution al study by Stover and colleagues showed that red cell transfusions varied by center, both in the percentage of patients receiving transfusions (17 -92%) and the number of units transfused (0 -4 units). 11 In this 24-center study, the variation could not be explained by patient variables, but rather, it was institutionally dependent. According to Spiess and colleagues, transfusion practices vary because neither an optimal Hct nor uniform transfusion criteria have been established.…”

mentioning

confidence: 74%

High or low hematocrits during cardiopulmonary bypass for patients undergoing coronary artery bypass graft surgery? An evidence-based approach to the question

Groom

2002

Perfusion

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We have observed an inverse relationship between a CPB Hct <20% and the need for cardiac support and hospital mortality. These data call for an aggressive and concerted effort to avoid a CPB Hct of <20%. The focus should be directed at women and small men since this subset of patients are most likely to experience low CPB Hct. A comprehensive, multimodality blood-conservation plan that involves the use of erythropoietin, aprotinin, preoperative autologous donation, shed blood reinfusion, and minimal phlebotomy for blood testing was proposed by Rosengart and colleagues based on their experience in caring for 50 Jehovah's Witness patients. Efforts to conserve blood and ensure hemostasis should cover the entire spectrum of care, including preoperative phlebotomy (for blood tests), diagnostic and interventional procedures, and intraoperative and postoperative care. Further work is needed to understand the mechanism for the relationship between low Hct and adverse outcomes. Each open-heart center should consider the Hct question carefully, examining both the published literature and their own results related to CPB Hct and patient outcomes.

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“…275,276 Newer research has shown that blood transfusion in the perioperative period actually has deleterious effects. It has been associated with a decrease in survival rates, with some studies citing up to a 70% increase in late mortality.…”

Section: Blood Transfusionmentioning

confidence: 99%

Current trends in preoperative, intraoperative, and postoperative care of the adult cardiac surgery patient

Szelkowski¹,

Puri²,

Singh³

et al. 2015

Current Problems in Surgery

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Variability in Transfusion Practice for Coronary Artery Bypass Surgery Persists Despite National Consensus Guidelines

Abstract: Institutions continue to vary significantly in their transfusion practices for CABG surgery. A more rational and conservative approach to transfusion practice at the institutional level is warranted.

Cited by 381 publications

References 8 publications

Prophylactic tranexamic acid in elective, primary coronary artery bypass surgery using cardiopulmonary bypass

Prophylactic tranexamic acid in elective, primary coronary artery bypass surgery using cardiopulmonary bypass

High or low hematocrits during cardiopulmonary bypass for patients undergoing coronary artery bypass graft surgery? An evidence-based approach to the question

Current trends in preoperative, intraoperative, and postoperative care of the adult cardiac surgery patient

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