The Association of Perioperative Red Blood Cell Transfusions and Decreased Long-Term Survival After Cardiac Surgery

Surgenor, Stephen D.; Kramer, Robert S.; Olmstead, Elaine M.; Ross, Cathy S.; Sellke, Frank W.; Likosky, Donald S.; Marrin, Charles A.S.; Helm, Robert E.; Leavitt, Bruce J.; Morton, Jeremy R.; Charlesworth, D.; Clough, Robert A.; Hernandez, Felix; Frumiento, Carmine; Benak, Arnold; Diodata, Christian; O’Connor, Gerald T.

doi:10.1213/ane.0b013e3181a2a696

Cited by 245 publications

(158 citation statements)

References 22 publications

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“…This is of much importance in surgeries performed in Jehova's Witnesses [8]. Several studies have shown that any amount greater than 1 unit of PRBC transfused, regardless of the procedure performed, results in decreased life expectancy of the patient [9][10][11]. In contrast to our study, other publications compared standard CPB with the system in which low crystalloid filling was used, and the postoperative day 1 drain output was comparable in both groups [12].…”

Section: Discussioncontrasting

confidence: 56%

Can cardiopulmonary bypass system with blood priming become a new standard in coronary surgery?

Mak¹,

Smolka

Kowalski

et al. 2016

Kardiol Pol

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A b s t r a c tBackground: Commonly used cardiopulmonary bypass systems with cardiotomy reservoir, oxygenator, and roller pump require preoperative crystalloid filling. Radical reduction of the filling fluid volume and replacing it with the patient's own blood has a fundamental impact on the outcome. Aim:A comparison of cardiopulmonary bypass filled with the patient's blood, applied in Poland for the first time, and the classical system filled with crystalloids.Methods: Non-randomised trial in which patients undergoing coronary artery bypass grafting were divided into two groups: first operated on with use of cardiopulmonary bypass system with the patient's own blood priming, and a control group operated on with standard technique. Levels of haemoglobin (HGB), haematocrit (HCT), platelets, leukocytes, creatinine, protein, C-reactive protein, procalcitonin, volume of transfused blood products, postoperative drain output, time to extubation, and consumption of catecholamines were compared. Results:The results of a study comparing the classical system with the blood-filled system (n = 60) showed a significantly smaller decrease in HGB and HCT levels (p = 0.001), resulting in reduction of blood product transfusions by 75% (p = 0.03). The new type of extracorporeal circulation reduced the total postoperative drain output by approximately 28% (p = 0.003). The systemic inflammatory response syndrome (SIRS) was less pronounced and the tissue perfusion was better due to smaller degree of haemodilution leading to better organ and heart protection. The patients required shorter mechanical ventilation times in the perioperative period. Conclusions:The use of a new system of cardiopulmonary bypass filled with the patient's blood reduces the postoperative decrease in HGB and HCT, the amount of transfused blood products, and total postoperative drain output. It also shortens the time spent on mechanical ventilatory support.

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Section: Discussioncontrasting

confidence: 56%

Can cardiopulmonary bypass system with blood priming become a new standard in coronary surgery?

Mak¹,

Smolka

Kowalski

et al. 2016

Kardiol Pol

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“…Blood transfusions after CABG have commonly been associated with increased long-term mortality (1)(2)(3)(4)(5)(6)(7)(8) as has CABG combined with AVR (9). We reached different results in a CABG population, where we extended the number of risk-factors entered in the survival analysis and did not find any association between transfusion of RBC and long-term survival in patients only undergoing CABG (10).…”

Section: Introductionmentioning

confidence: 87%

Risks Associated With the Transfusion of Various Blood Products in Aortic Valve Replacement

Bjursten

Al-Rashidi

Dardashti

et al. 2013

The Annals of Thoracic Surgery

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“…37 Observational studies have found higher postoperative mortality rates in transfused patients undergoing cardiac surgery compared with those who were not transfused, even after adjustment for other risk factors. 38 Randomized controlled trials (RCTs) in patients undergoing cardiac surgery have shown that white blood cell (WBC)-reduced blood products carry a lower mortality risk than non-WBC-reduced products. 23 However, this has not been observed after other types of surgery, and this issue is not resolved.…”

Section: Transfusion and Preoperative Anaemiamentioning

confidence: 99%

Patient Blood Management in Europe

Shander¹,

Aken²,

Gombotz³

et al. 2013

Survey of Anesthesiology

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The Association of Perioperative Red Blood Cell Transfusions and Decreased Long-Term Survival After Cardiac Surgery

Abstract: Exposure to 1 or 2 U of RBCs was associated with a 16% increased hazard of decreased survival after cardiac surgery.

Cited by 245 publications

References 22 publications

Can cardiopulmonary bypass system with blood priming become a new standard in coronary surgery?

Can cardiopulmonary bypass system with blood priming become a new standard in coronary surgery?

Risks Associated With the Transfusion of Various Blood Products in Aortic Valve Replacement

Patient Blood Management in Europe

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