Use of blood products in cardiac surgery

Abstract

The quantity of blood products used perioperatively during cardiac surgery is known to vary widely between institutions. This study looked at the amount of blood products used perioperatively in 74 consecutive elective cardiac operations in one institution. The results are compared with those from other European centres and a cost analysis carried out. On average 2.33 +/- 0.74 (95% confidence interval 1.93-2.77) units of red cell concentrate were transfused perioperatively per patient. Six (8%) patients received no blood products. In addition a number of preoperative factors were studied in an attempt to identify predictors of transfusion requirements. Age, preoperative haemoglobin, female sex and red cell mass were all found to have some predictive value. In the face of increasing demands on a limited supply of blood products we question the need for cross matching more than four units of red cell concentrate in elective cardiac surgery.

Mechanical methods of reducing blood transfusion in cardiac surgery: randomised controlled trial

“…1 2 Up to 92% of patients presenting for elective cardiac surgery receive blood 3. In our own institution recently this proportion was 82% 4.…”

Risk factors for red cell transfusion in adults undergoing coronary artery bypass surgery: a systematic review

“…Transfusion rates ranged from 10 to 97% in studies that defined a transfusion trigger and 7 to 73% in studies that did not define these triggers (Tables 3 and 4). Transfusion rates also varied across a very wide range for both teaching/university hospitals, 7 to 80%[2,6–8,11,14,20], and non‐teaching hospitals, 11 to 97%[1,3–5,10,12,13,18,21,22]. Transfusion rates did not appear to differ according to the transfusion interval included (i.e.…”

“…Coronary artery bypass graft (CABG) surgery is a surgical procedure with considerable variability in rates of red cell transfusion [1–14], as well as a procedure associated with one of the highest rates of transfusion [15]. To optimize transfusions in adult patients, the factors that guide the decision to transfuse need to be determined to resolve whether these factors should in fact influence transfusion decisions.…”

A multivariable model for predicting the need for blood transfusion in patients undergoing first‐time elective coronary bypass graft surgery

“…Preoperative patient variables that have previously been shown to be associated with the need for blood transfusion during elective CABG surgery were included in the analysis ( Table 2). [1][2][3][4][5][11][12][13][14][15][16][17] These are factors associated with low preoperative RBC volume and comorbid conditions and diseases. 2 In addition, three transfusion-related perioperative variables 16,18 (Table 2) were collected, and their impact on perioperative transfusion was assessed.…”