Transfusion triggers in cardiac surgery: Where do we go from here?

Patel, Nishith; Murphy, Gavin J.

doi:10.1007/s12630-018-1150-y

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…The authors report, as potential physiologic triggers, a mean arterial pressure < 60 mmHg (or < 70-80% of baseline), heart rate > 110-130 beats/min (or > 120-130% of baseline), new ST-segment depression or elevation of at least 0.1 mV in an electrocardiogram, new wall motion abnormality on transesophageal or transthoracic echocardiography, mixed venous oxygen partial pressure < 32 mmHg, oxygen extraction ratio > 40%, mixed venous oxygen saturation < 60%, or > 10% decrease in oxygen consumption (VO 2 ). 20 Nowadays, thromboelastography (TEG) and thromboelastometry (ROTEM ® ) have been considered of great value in cardiac surgery. Kozek et al, 21 reported that TEG or ROTEM-guided hemostatic therapy reduces the number of patients requiring RBC, FFP and platelet transfusions, providing a more restrictive strategy than that based on conventional laboratory testing.…”

Section: Discussionmentioning

confidence: 99%

Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study

Tagliari

Silveira

Kochi

et al. 2019

International Journal of Cardiovascular Sciences

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Background: Hemodilution, transoperative bleeding and cardiopulmonary bypass (CPB) are some of the factors associated with high transfusion rates in cardiac surgery. Objective:To analyze the incidence of blood transfusion and early postoperative outcomes in cardiac surgery patients.Methods: Cohort study of patients undergoing cardiac surgery in a university hospital, consecutively enrolled from May 2015 to February 2017. Data were prospectively collected and comparisons were made between two patients' groups: transfused and not transfused. Student's t-test, chi-square test, and logistic regression were used, and a p-value < 0.05 was considered significant.Results: Among the 271 patients evaluated, 100 (37%) required transfusion in the transoperative (32.1%) and/or postoperative periods (19.5%). The following predictors of transfusion were identified by multivariate analysis: EuroScore II (OR 1.2); chronic kidney disease (CKD) (OR 3.2); transoperative bleeding ≥ 500 mL (OR 6.7); baseline hemoglobin (Hb) ≤ 10 g/dL (OR 11.5); activated partial thromboplastin time (aPTT) (OR 1.1) and CPB duration (OR 1.03). Transfusion was associated with prolonged mechanical ventilation (≥ 24h) (2.4% vs. 23%), delirium (5.9% vs. 18%), bronchopneumonia (1.2% vs. 16%), acute renal failure (3.5% vs. 25%), acute on CKD (0.6% vs. 8%), stroke or transient ischemic attack (1.8% vs. 8%), intensive care unit stay ≥ 72 h (36% vs. 57%), longer hospital stay (8 ± 4 days vs. 16 ± 15 days), as well as increased early mortality (1.75% vs. 15%). Conclusion:EuroScore II, CKD, major transoperative bleeding, preoperative Hb and aPTT values and CPB time were independent predictors of transfusion, which was associated with a higher rate of adverse outcomes, including early mortality.

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Section: Discussionmentioning

confidence: 99%

Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study

Tagliari

Silveira

Kochi

et al. 2019

International Journal of Cardiovascular Sciences

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Erythrocyte Transfusion: Brief History and Current Practice

Biro

2022

Blood Substitutes and Oxygen Biotherapeutics

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Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery

et al. 2018

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In patients undergoing cardiac surgery who were at moderate-to-high risk for death, a restrictive strategy for red-cell transfusion was noninferior to a liberal strategy with respect to the composite outcome of death from any cause, myocardial infarction, stroke, or new-onset renal failure with dialysis at 6 months after surgery. (Funded by the Canadian Institutes of Health Research and others; TRICS III ClinicalTrials.gov number, NCT02042898 .).

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Transfusion triggers in cardiac surgery: Where do we go from here?

Cited by 3 publications

References 12 publications

Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study

Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study

Erythrocyte Transfusion: Brief History and Current Practice

Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery

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