Transfusion in the cardiac patient

Spahn, Donat R.; Dettori, Nadia; Kocián, Roman; Chassot, Pierre‐Guy

doi:10.1016/s0749-0704(03)00112-x

Cited by 18 publications

(12 citation statements)

References 44 publications

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“…This may be attributable to the fact that these patients had more transfusions, which increased the risk of joint infection and consequently increased the risk of reoperation [18,33]. Patients with coronary artery disease have more transfusions to maintain hemoglobin levels that prevent tachycardia and possible myocardial ischemia [41].…”

Section: Discussionmentioning

confidence: 99%

2010 Mid-America Orthopaedic Association Physician in Training Award: Predictors of Early Adverse Outcomes after Knee and Hip Arthroplasty in Geriatric Patients

Elsharkawy

Klika

Brocone

et al. 2011

Clinical Orthopaedics &Amp; Related Research

116

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Background Geriatric patients experience more adverse events owing to early complications after TKA or THA related to preexisting comorbidities. However, associations between patient and surgery variables, including age, BMI, and comorbidities with complications are unclear. Knowing these relationships is necessary for developing risk stratification, defining contraindications, and predicting complications and adverse outcomes.Questions/purposes We wished to establish and quantify the associations among age, BMI, comorbidities, and type of surgery and anesthesia with complications and early adverse outcomes including longer length of stay, disposition to an extended care facility, readmission, and reoperation in geriatric patients undergoing TKA and THA. Patients and Methods We prospectively followed a cohort of patients older than 65 years undergoing TKA or THA. Demographics, comorbidities, complications, discharge disposition, readmission, and/or reoperation information within the 90-day postoperative period were collected. Adjusted hierarchical stepwise multivariable regression models were used to analyze associations and relative risks with complications, length of stay, disposition, readmission, and reoperation rates.

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Section: Discussionmentioning

confidence: 99%

2010 Mid-America Orthopaedic Association Physician in Training Award: Predictors of Early Adverse Outcomes after Knee and Hip Arthroplasty in Geriatric Patients

Elsharkawy

Klika

Brocone

et al. 2011

Clinical Orthopaedics &Amp; Related Research

116

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“…Patients with significant mitral insufficiency, including those with atrial fibrillation, tolerate moderate haemodilution to a haemoglobin level of 10 g/dL (6.1 mmol/L) [72]. Tolerance of acute haemodilution or anaemia in patients with other valve abnormalities is less well known.…”

Section: Circulation and Red Blood Cells (Haemoglobin)mentioning

confidence: 99%

Transfusion Strategy: Impact of Haemodynamics and the Challenge of Haemodilution

Jakobsen

2014

Journal of Blood Transfusion

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Blood transfusion is associated with increased morbidity and mortality and numerous reports have emphasised the need for reduction. Following this there is increased attention to the concept of patient blood management. However, bleeding is relatively common following cardiac surgery and is further enhanced by the continued antiplatelet therapy policy. Another important issue is that cardiopulmonary bypass leads to haemodilution and a potential blood loss. The basic role of blood is oxygen transport to the organs. The determining factors of oxygen delivery are cardiac output, haemoglobin, and saturation. If oxygen delivery/consumption is out of balance, the compensation mechanisms are simple, as a decrease in one factor results in an increase in one or two other factors. Patients with coexisting cardiac diseases may be of particular risk, but studies indicate that patients with coexisting cardiac diseases tolerate moderate anaemia and may even benefit from a restrictive transfusion regimen. Further it has been shown that patients with reduced left ventricular function are able to compensate with increased cardiac output in response to bleeding and haemodilution if normovolaemia is maintained. In conclusion the evidence supports that each institution establishes its own patient blood management strategy to both conserve blood products and maximise outcome.

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“…Bir dk. 'dan daha uzun süren yeni ST segment depresyonu (>0.1 mv) veya yeni ST segment elevasyonu (>0.2 mv), transözofageal ekokardiyografide yeni ventrikül duvar hareket anormalliklerinin saptanması, miyokardiyal iskeminin bulguları olarak kabul edilebilir (86) . Önemli bir nokta, hemodilüsyona bağlı bu miyokart iskemisinin, hemoglobin konsantrasyonunun bir miktar arttırılması veya kalp hızının düşürülmesi ile düzelebilmesidir (87,88) .…”

Section: Fizyolojik Kriterlerunclassified

Transfusion Triggers in Cardiac Surgery

Güler¹

2012

GKDA Derg

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Transfusion in the cardiac patient

Cited by 18 publications

References 44 publications

2010 Mid-America Orthopaedic Association Physician in Training Award: Predictors of Early Adverse Outcomes after Knee and Hip Arthroplasty in Geriatric Patients

2010 Mid-America Orthopaedic Association Physician in Training Award: Predictors of Early Adverse Outcomes after Knee and Hip Arthroplasty in Geriatric Patients

Transfusion Strategy: Impact of Haemodynamics and the Challenge of Haemodilution

Transfusion Triggers in Cardiac Surgery

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