Low Hematocrit During Cardiopulmonary Bypass is Associated With Increased Risk of Perioperative Stroke in Cardiac Surgery

Reassessing the risk of hemodilutional anemia: Some new pieces to an old puzzle

“…However, recent clinical and experimental studies have demonstrated that acute hemodilution can reduce tissue oxygen delivery to vital organs and increase organ injury and mortality. 2,[11][12][13][14] These data provide evidence that acute normovolemic hemodilution may be detrimental. The focus of the current review is on the risk associated with acute hemodilution (normovolemia) and not hemorrhage and hypotension (hypovolemia).…”

“…2,[15][16][17] Hemodilution increases the risk of stroke Acute stroke is a catastrophic complication associated with hemodilution during cardiopulmonary bypass (CPB). 2,12 Although exact mechanisms have not been defined, experimental studies suggest that tissue hypoxia contributes. 18 While a specific safe threshold hematocrit has not been established, prevention of a fall in the hematocrit to \ 25% may be beneficial in terms of reduced neurological injury and morbidity.…”

Optimising the management of breast cancer in older patients

“…Results of the statistical analysis were reviewed and confirmed by a Bootstrapping is a valid method for internal replication & validation of statistical analysis and has been used in other medical studies [106,107]. The bootstrap method analyses results by replication across studies, mixing up the participants in a given study in many different ways, to determine whether the results are stable across numerous combinations of study participants [108].…”

Assessment and treatment of preoperative anemia: Continuing Professional Development

“…While some patients tolerate Hb levels near 70 gÁL -1 , in others, mortality and neurological injury is increased following cardiopulmonary bypass near this threshold. 19,20 Indeed, the optimal Hb threshold may be even higher (100 gÁL -1 ) for patients suffering from neurotrauma or acute coronary syndromes. 21,22 The physiological response to anemia Acute anemia provides a primary ''hypoxic'' stimulus by decreasing blood oxygen content and reducing oxygen delivery to tissue.…”

“…En effet, alors que certains patients tolèrent des niveaux de Hb avoisinant 70 gÁL -1 , chez d'autres, la mortalité et les lésions neurologiques augmentent à la suite d'une circulation extracorporelle avec un niveau proche de ce seuil. 19,20 En fait, le seuil de Hb optimal pourrait être encore plus élevé (100 gÁL -1 ) chez les patients atteints d'un traumatisme neurologique ou de syndromes coronariens aigus. 21,22 La réponse physiologique à l'anémie L'anémie aiguë fournit un stimulus 'hypoxique' primaire en réduisant le contenu d'oxygène dans le sang et l'apport d'oxygène aux tissus.…”