scholarly journals Ulinastatin reduces postoperative bleeding and red blood cell transfusion in patients undergoing cardiac surgery

Medicine ◽  
2020 ◽  
Vol 99 (7) ◽  
pp. e19184
Author(s):  
Yun-Tai Yao ◽  
Neng-Xin Fang ◽  
Ding-Hua Liu ◽  
Li-Huan Li
Keyword(s):  
Cardiac Surgery ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Postoperative Bleeding ◽  
Red Blood Cell Transfusion

scholarly journals BLOOD TRANSFUSION IN CARDIAC SURGERY- NEED TO FOLLOW BASICS!

2020 ◽  
Vol 7 (3) ◽  
Keyword(s):  
Cardiac Surgery ◽  
Blood Transfusion ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Transfusion Strategy ◽  
Transfusion Threshold ◽  
Restrictive Transfusion ◽  
Conflicting Evidence ◽  
American Society

More and more data is coming in recent times about hazards of blood transfusion. In a landmark TRICC1 trial Euvolemic patients in the intensive care unit (ICU) with Hb<9 g/dl were randomized to a restrictive transfusion strategy for transfusion of PRBCs (transfused if Hb<7 g/dl to maintain Hb between 7 and 9 g/dl) or a liberal strategy (transfused if Hb<10 g/dl to maintain Hb 10-12 g/dl). Mortality was similar in both groups, indicating that liberal transfusions were not beneficial. An Updated Report by the American Society of AnaesthesiologistsTask Force on Perioperative Blood Management tells us restrictive red blood cell transfusion strategy may be safely used to reduce transfusion administration. It further states that The determination of whether hemoglobin concentrations between 6 and 10 g/dl justify or require red blood cell transfusion should be based on potential or actual on going bleeding (rate and magnitude), intravascular volume status, signs of organ ischemia, and adequacy of cardiopulmonary reserve. Should we extrapolate these guidelines in Cardiac surgery? TRACS2 trial concluded that among patients undergoing cardiac surgery, the use of a restrictive perioperative transfusion strategy compared with a more liberal strategy resulted in noninferior rates of the combined outcome of 30-day all-cause mortality and severe morbidity.They advocated use of restrictive strategy, but 5 years later, the authors 3concluded that A restrictive transfusion threshold after cardiac surgery was not superior to a liberal threshold with respect to morbidity or health care costs. With this conflicting evidence, by which way anaesthesiologist to go?

Individualised or liberal red blood cell transfusion after cardiac surgery: a randomised controlled trial

2021 ◽  
Author(s):  
Marc-Olivier Fischer ◽  
Pierre-Grégoire Guinot ◽  
Stéphane Debroczi ◽  
Pierre Huette ◽  
Christophe Beyls ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Randomised Controlled Trial ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Controlled Trial ◽  
Red Blood Cell Transfusion ◽  
Randomised Controlled

Impact of minimal invasive extracorporeal circulation on the need of red blood cell transfusion

Perfusion ◽  
2019 ◽  
Vol 34 (7) ◽  
pp. 605-612 ◽  
Author(s):  
Sten Ellam ◽  
Otto Pitkänen ◽  
Pasi Lahtinen ◽  
Tadeusz Musialowicz ◽  
Mikko Hippeläinen ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Extracorporeal Circulation ◽  
Odds Ratio ◽  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Minimal Invasive ◽  
Red Blood Cell Transfusion ◽  
Red Blood Cell Transfusions ◽  
Hemoglobin Drop

Objective: Minimal invasive extracorporeal circulation may decrease the need of packed red blood cell transfusions and reduce hemodilution during cardiopulmonary bypass. However, more data are needed on the effects of minimal invasive extracorporeal circulation in more complex cardiac procedures. We compared minimal invasive extracorporeal circulation and conventional extracorporeal circulation methods of cardiopulmonary bypass. Methods: A total of 424 patients in the minimal invasive extracorporeal circulation group and 844 patients in the conventional extracorporeal circulation group undergoing coronary artery bypass grafting and more complex cardiac surgery were evaluated. Age, sex, type of surgery, and duration of perfusion were used as matching criteria. Hemoglobin <80 g/L was used as red blood cell transfusion trigger. The primary endpoint was the use of red blood cells during the day of operation and the five postoperative days. Secondary endpoints were hemodilution (hemoglobin drop after the onset of perfusion) and postoperative bleeding from the chest tubes during the first 12 hours after the operation. Results: Red blood cell transfusions were needed less often in the minimal invasive extracorporeal circulation group compared to the conventional extracorporeal circulation group (26.4% vs. 33.4%, p = 0.011, odds ratio 0.72, 95% confidence interval 0.55-0.93), especially in coronary artery bypass grafting subgroup (21.3% vs. 35.1%, p < 0.001, odds ratio 0.50, 95% confidence interval 0.35-0.73). Hemoglobin drop after onset of perfusion was also lower in the minimal invasive extracorporeal circulation group than in the conventional extracorporeal circulation group (24.2 ± 8.5% vs. 32.6 ± 12.6%, p < 0.001). Postoperative bleeding from the chest tube did not differ between the groups (p = 0.808). Conclusion: Minimal invasive extracorporeal circulation reduced the need of red blood cell transfusions and hemoglobin drop when compared to the conventional extracorporeal circulation group. This may have implications when choosing the perfusion method in cardiac surgery.

779 Increasing Volume of Packed Red Blood Cell Transfusion is Associated With In-Hospital Adverse Events Following Cardiac Surgery

2012 ◽  
Vol 28 (5) ◽  
pp. S398-S399
Author(s):  
A. Hassan ◽  
J.B. MacLeod ◽  
A.M. Yip ◽  
M. Ouzounian ◽  
S. Lutchmedial ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Adverse Events ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion
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