Critical Preoperative Hemoglobin Value to Predict Anemia-Related Complications After Cardiac Surgery

Kattou, Fehmi; Montandrau, Olivier; Rekik, Mohamed Ali; Delentdecker, Philippe; Brini, Kais; Zannis, Konstantinos; Beaussier, Marc

doi:10.1053/j.jvca.2022.01.013

Cited by 10 publications

(6 citation statements)

References 30 publications

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“…As was investigated, iron deficiency, female, and hemoglobin were found to be clinically relevant to intraoperative RBC transfusion in our study. Of note, hemoglobin was also shown as a protector of intraoperative RBC transfusion, which was consistent with previous studies ( 26 ). A higher concentration of hemoglobin could enhance the oxygen-carrying capacity of blood, which could obviously improve tolerance to blood loss.…”

Section: Discussionsupporting

confidence: 91%

Clinical presentation and in-hospital outcomes of intraoperative red blood cell transfusion in non-anemic patients undergoing elective valve replacement

Zhang

Qian

et al. 2022

Front. Cardiovasc. Med.

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BackgroundIntraoperative transfusion is associated with adverse clinical outcomes in cardiac surgery. However, few studies have shown the impact of intraoperative red blood cell (RBC) transfusion on non-anemic patients undergoing cardiac surgery. We assessed the in-hospital clinical outcomes of non-anemic patients undergoing isolated valve replacements and investigated the predictors associated with intraoperative RBC transfusion.MethodsWe enrolled 345 non-anemic patients undergoing isolated valve replacements in our department from January 2015 to December 2019. The patients were stratified by the receipt of intraoperative RBC transfusion. Baseline characteristics were compared between groups and multiple logistic regression was used to identify the predictors for intraoperative RBC transfusion. The association between intraoperative RBC transfusion and in-hospital outcomes was also evaluated.ResultsIntraoperative RBC transfusion developed in 84 of the 345 enrolled patients (24.3%). Three independent predictors for intraoperative RBC transfusion of non-anemic patients undergoing isolated valve replacements were identified by multivariate logistic analysis, including female, iron deficiency and hemoglobin level. When the two groups were compared, a significant tendency of higher in-hospital mortality (6.0% vs. 1.1%, P = 0.033) and higher incidence of postoperative hypoxemia (9.5% vs. 2.7%, P = 0.007) were observed in the intraoperative RBC transfusion group. After adjustment, the presence of intraoperative RBC transfusion was associated with an increase in postoperative hypoxemia (OR = 3.36, 95% CI: 1.16–9.71, P = 0.026).ConclusionIntraoperative RBC transfusion was associated with poorer clinical outcomes in non-anemic adults undergoing isolated valve replacements, which significantly increased the risk of postoperative hypoxemia. The independent predictors of intraoperative RBC transfusion, such as iron deficiency and female, were identified, which may be helpful for risk assessment and perioperative management.

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Section: Discussionsupporting

confidence: 91%

Clinical presentation and in-hospital outcomes of intraoperative red blood cell transfusion in non-anemic patients undergoing elective valve replacement

Zhang

Qian

et al. 2022

Front. Cardiovasc. Med.

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“…mente, Kattou et al, describieron en sujetos de cirugía cardíaca una relación entre valores bajos de hemoglobina preoperatoria y complicaciones posoperatorias entre las cuales se encontraba la IRAP. No obstante, los valores de corte identificados como predictores fueron superiores a los propuestos en este estudio (Hb < 13 g/dL para hombres y < 11,8 g/dL para mujeres) [7]. Este y otros estudios similares reportaron una incidencia de IRAP similar a la obtenida en nuestro trabajo [1], [2], [3].…”

Section: Discussionunclassified

Injuria renal aguda posoperatoria luego de cirugía mayor no cardíaca en la era de la Gestión de la Sangre del Paciente

2024

Rev. chil. anest.

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“…As a result, after transfusion, they can promote a proinflammatory state, impair tissue oxygen delivery, and exacerbate tissue oxidative stress. This in turn can contribute to organ dysfunction and explain, at least in part, the increased hospital mortality and morbidity ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

How Important Impact of Low Level of Hematocrit Can Be on Outcome in Patients Undergoing Off Pump Coronary Artery Bypass Surgery?

Štraus¹,

Karabdic²,

Grabovica³

et al. 2023

Acta Inform Med

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Background: Cardiosurgical patients can be often anemic, and preoperative anaemia is associated with increased postoperative complications, as well as morbidity and mortality. Objective: The present study was conducted aiming to determine the influence of lower preoperative hematocrit values on the early postoperative recovery of patients undergoing elective off-pump coronary artery bypass grafting (OPCABG). Methods: Our retrospective study included 150 patients who underwent elective OPCABG surgery from September 2021 to December 2022 at the Clinic for Cardiovascular Surgery University of Sarajevo. Patients were divided into two groups, anemic and non-anemic, with anemia defined as hemoglobin level <130g/l males and <120g/l females. Study observed comorbidities and early postoperative data. Results: Overall prevalence of anemia in OPCABG patients was 36,6%, more frequent among older patients. Comorbidities as chronic obstructive pulmonary disease, hypertension, ejection fraction was quite similar in both groups, but body mass index was significantly higher in the group of patients with anemia (29.9% vs 28.4%). In early recovery period, vasopressors were more used in patients with anemia (63.6% vs 42.1%) and their doses were higher. Total drainage was higher in patients with anemia (744.45±45.72 ml vs 681.58±349.06 ml). Number of transfusions was higher in the group of patients with anemia: red blood cells (0.89±1.29 vs 0.29±0.84; p<0,05), fresh frozen plasma (0.65±1.13 vs 0.41±1.15; p<0,05) and platelets (0.11±0.57 vs 0,07±0.42; p>0,05). Duration of mechanical ventilation was longer in patients with anemia compared to non-anemic patients (623-91±259.83 minutes vs 469±191.13 minutes). Atrial fibrillation occurred more often in patients with anemia (12.7 vs 7.4%). Length of stay in the intensive care unit was without significant difference. Conclusion: Based on our findings, patients who underwent elective OPCABG with lower than normal hematocrit, needed more blood and blood products, more vasopressor drugs in higher doses, longer mechanical ventilation, all which can prolong the patient’s recovery and increase the cost of treatment.

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Critical Preoperative Hemoglobin Value to Predict Anemia-Related Complications After Cardiac Surgery

Cited by 10 publications

References 30 publications

Clinical presentation and in-hospital outcomes of intraoperative red blood cell transfusion in non-anemic patients undergoing elective valve replacement

Clinical presentation and in-hospital outcomes of intraoperative red blood cell transfusion in non-anemic patients undergoing elective valve replacement

Injuria renal aguda posoperatoria luego de cirugía mayor no cardíaca en la era de la Gestión de la Sangre del Paciente

How Important Impact of Low Level of Hematocrit Can Be on Outcome in Patients Undergoing Off Pump Coronary Artery Bypass Surgery?

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