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

Journal of Cardiothoracic and Vascular Anesthesia
Esther K HogervorstNardo J M van der Meer

Abstract

Increasing evidence suggests benefits from restrictive red blood cell transfusion (RBC) thresholds in major surgery and critically ill patients. However, these benefits are not obvious in cardiac surgery patients with intraoperative anemia. The authors examined the association between uncorrected hemoglobin (Hb) levels and selected postoperative outcomes as well as the effects of RBCs. Cohort study with prospectively collected data from a cardiac surgery registry. A major cardiac surgical hospital within the Netherlands, which is also a referral center for Jehovah's Witnesses. Patients (23,860) undergoing cardiac surgery between 1997 and 2013. Comparisons were done in patients with intraoperative nadir Hb<8 g/dL and/or an Hb decrease ≥ 50%. Comparison (A) between Jehovah's Witnesses (Witnesses) and matched non-Jehovah's Witnesses (non-Witnesses) transfused with 1 unit of RBC, and comparison (B) between patients given 1 unit of RBC intraoperatively versus matched non-transfused patients. Postoperative outcomes were myocardial infarction, renal replacement therapy, stroke, and death. With propensity matching, the authors optimized exchangeability of the compared groups. Adverse outcomes increased with a decreasing Hb both among W...Continue Reading

References

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Citations

Sep 20, 2016·World Neurosurgery·Douglas A HardestyPeter D LeRoux
May 6, 2019·BMC Anesthesiology·Eline A VlotPeter G Noordzij
Dec 17, 2020·Perfusion·Aimee-Louise ChambaultAmer Harky
Jul 12, 2020·American Journal of Obstetrics and Gynecology·Rebecca F HammSindhu K Srinivas
Aug 8, 2021·Khirurgiia·V V BasylevM A Pantyukhina

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