Dose-Dependent Effects of Intraoperative Low Volume Red Blood Cell Transfusions on Postoperative Outcomes in Cardiac Surgery Patients

Publication Date

2014

Journal Title

J Cardiothorac Vasc Anesth

Abstract

Objective: To determine the incremental risk associated with each intraoperative red blood cell transfusion in cardiac surgery patients. Design: Retrospective analysis on prospectively collected data. Setting: Single tertiary care hospital. Participants: Seven hundred forty-five patients undergoing on-pump cardiac surgery between January 2010 and June 2012 who received between 1 and 3 units of red blood cell transfusion intraoperatively. Interventions: All patients received between 1 and 3 units of red blood cell transfusions. All transfusions were with leukoreduced blood that had been stored forhours, 12 hours, and 13 hours in patients receiving 1, 2, and 3 units of red blood cell transfusions, respectively (p < 0.005). Similarly, each additional unit of red blood cell transfusion was associated with increasing postoperative septicemia (0% v 0.35% v 2.29%, p < 0.006) and postoperative pneumonia (0% v 0.70% v 2.29%, p < 0.013). Conclusions: There is a step-wise increase in length of postoperative intubation with each red blood cell transfusion in patients undergoing cardiac surgery. Each additional unit of intraoperative RBC transfusion also may increase postoperative infectious complications. Thus, even single-unit reductions in red blood cell transfusions may have significant impact on outcomes. (C) 2014 Elsevier Inc. All rights reserved.

Volume Number

28

Issue Number

6

Pages

1545-1549

Document Type

Article

EPub Date

2014/09/30

Status

Faculty, Northwell Researcher

Facility

School of Medicine; Northwell Health

Primary Department

Cardiovascular and Thoracic Surgery

Additional Departments

General Internal Medicine

PMID

25263773

DOI

10.1053/j.jvca.2014.05.025

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