Intraoperative Anemia and Single Red Blood Cell Transfusion During Cardiac Surgery: An Assessment of Postoperative Outcome Including Patients Refusing Blood Transfusion

Hogervorst, Esther K.; Rosseel, Peter; Watering, Leo M.G. van de; Brand, Anneke; Bentala, M.; Bom, Johanna G. van der; Meer, Nardo J. M. van der

doi:10.1053/j.jvca.2015.10.021

Cited by 26 publications

(40 citation statements)

References 37 publications

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“…Patient blood management approach may greatly improve the outcomes of patients at risk for significant blood loss and need of blood transfusion . In particular, perioperative optimization of Hb levels with iron and erythropoiesis‐stimulating agents (ESAs) may play a crucial role in the management of JWs.…”

Section: Discussionmentioning

confidence: 99%

“…16 Patient blood management approach may greatly improve the outcomes of patients at risk for significant blood loss and need of blood transfusion. 19,20 In particular, perioperative optimization of Hb levels with iron and erythropoiesis-stimulating agents (ESAs) may play a crucial role in the management of JWs. Importantly, despite the fact that transfusions are associated with adverse events and hospital costs, low preoperative Hct and Hb are also predictors for postoperative complications in cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

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Outcome of Jehovah's Witnesses after adult cardiac surgery: systematic review and meta‐analysis of comparative studies

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Outcome of Jehovah's Witnesses after adult cardiac surgery: systematic review and meta‐analysis of comparative studies

et al. 2016

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“…Most common comorbidities were hypertension (61%), diabetes mellitus (25%) and peripheral artery disease (12%). Median EuroSCORE was four [2][3][4][5][6] and 729 (25%) patients had a reduced LVEF (≤ 50%) prior to surgery. A majority of patients (87%) underwent isolated CABG surgery, IMA was used for grafting in 91% of cases and median duration of operation was 195 min .…”

Section: Study Population and Baseline Characteristicsmentioning

confidence: 99%

“…A total of 647 (22%) patients received a median of 3 [2][3][4] units of any intraoperative allogeneic transfusion. Plasma transfusion occurred in 210 patients (7%) with a median of 2 [2] units and platelet transfusion was performed in 567 patients (19%) with a median of 1 [1,2] units.…”

Section: Intra-operative Transfusionsmentioning

confidence: 99%

“…In patients with coronary disease these compensatory mechanisms are limited and without treatment anemia may lead to myocardial ischemia and subsequent myocardial infarction. Anemia in cardiac surgery patients is common and has been associated with poor outcome [1][2][3]. During surgery, ongoing blood loss and hemodilution as a result of cardiopulmonary bypass (CPB) causes low hemoglobin (Hb) levels.…”

Section: Introductionmentioning

confidence: 99%

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Intra-operative red blood cell transfusion and mortality after cardiac surgery

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et al. 2019

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Background Anemia in cardiac surgery patients has been associated with poor outcomes. Transfusion of red blood cells during surgery is common practice for perioperative anemia, but may come with risks. Little is known about the association between intra-operative transfusion and mortality in patients undergoing cardiac surgery. Methods Single centre historical cohort study in 2933 adult patients undergoing coronary surgery with or without aortic valve replacement from June 2011 until September 2014. To estimate the odds ratio for mortality in patients receiving intra-operative transfusion, a propensity score based logistic regression analysis was performed. Results Intra-operative transfusion was associated with a more than three-fold increased risk of 30-day mortality. Patients in the highest quartile of probability of transfusion were older (age 75 vs 66; P<0.001), had a higher EuroSCORE (6 vs 3; P<0.001), had lower preoperative hemoglobin levels (7.6 vs 8.9 mmol/l; P<0.001), had combined surgery more often (CABG + AVR in 33.4% of cases vs 6.6% (P<0.001) and a longer duration of surgery (224 vs 188 minutes; P<0.001). The association between intra-operative transfusion and mortality persisted after adjustment for these risk factors (adjusted OR 2.6; P=0.007). Conclusions Intra-operative transfusion of red blood cells was found to be associated with increased mortality in adults undergoing coronary surgery. Preoperative patient optimization may improve perioperative outcomes by reducing the likelihood of requiring transfusion and thus its associated risk.

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The Jehovah’s Witness

Rosseel¹

2019

Patient Blood Management in Cardiac Surgery

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Intraoperative Anemia and Single Red Blood Cell Transfusion During Cardiac Surgery: An Assessment of Postoperative Outcome Including Patients Refusing Blood Transfusion

Cited by 26 publications

References 37 publications

Outcome of Jehovah's Witnesses after adult cardiac surgery: systematic review and meta‐analysis of comparative studies

Outcome of Jehovah's Witnesses after adult cardiac surgery: systematic review and meta‐analysis of comparative studies

Intra-operative red blood cell transfusion and mortality after cardiac surgery

The Jehovah’s Witness

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