Acute traumatic coagulopathy and the relationship to prehospital care and on‐scene red blood cell transfusion

The change in hematocrit (ΔHct) following packed red blood cell (pRBCs) transfusion is a clinically relevant measurement of transfusion efficacy that is influenced by post-transfusion hemolysis. Sexual dimorphism has been observed in critical illness and may be related to gender-specific differences in immune response. We investigated the relationship between both donor and recipient gender and ΔHct in an analysis of all pRBCs transfusions in our surgical intensive care unit (2006–2009). The relationship between both donor and recipient gender and ΔHct (% points) was assessed using both univariate and multivariable analysis. A total of 575 units of pRBCs were given to 342 patients; 289 (49.9%) donors were male. By univariate analysis, ΔHct was significantly greater for female as compared to male recipients (3.81% versus 2.82%, resp., ). No association was observed between donor gender and ΔHct, which was 3.02% following receipt of female blood versus 3.23% following receipt of male blood (). By multivariable analysis, recipient gender remained associated significantly with ΔHct (). In conclusion, recipient gender is independently associated with ΔHct following pRBCs transfusion. This association does not appear related to either demographic or anthropomorphic factors, raising the possibility of gender-related differences in recipient immune response to transfusion.

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Red Blood Cell Transfusion and its Relationship with Pedicle Thrombosis in Microvascular Free Flaps

Journal of Reconstructive Microsurgery ◽

10.1055/s-0041-1733994 ◽

2021 ◽

Author(s):

Carlos Eduardo Torres Fuentes ◽

Iván Enrique Rodríguez Mantilla ◽

Diego Nicolás Guerrero Cáceres ◽

Diego Felipe Camargo Gonzalez

Keyword(s):

Blood Cell ◽

Free Flap ◽

Red Blood Cell ◽

Cox Regression ◽

Free Flaps ◽

Perioperative Period ◽

Red Blood Cell Transfusion ◽

Flap Survival ◽

Increased Risk ◽

The Relationship

Abstract Background Free flaps have become a highly valuable tool for complex reconstructive surgeries. The requirement of red blood cell transfusion (RBCT) during the perioperative period is common and its effect on the free flap survival is debatable. The aim of this study was to determine the relationship between perioperative RBCT and vascular pedicle thrombosis (VPT). Methods For this study 302 free flaps performed between January 2006 and December 2019 were retrospectively analyzed. It included their characteristics from before, during, and after the surgical procedure. The incidence of VPT and flap survival were calculated based on Kaplan Meier's method and the relationship between VPT and perioperative variables were analyzed by Cox regression models. Results The transfusion group was represented by 62 flaps (20.5%) and no transfusion by 240 flaps. The overall transfusion requirement was 20.5% and the cumulative incidence of VPT was 9.11%. A statistically significant relationship was not demonstrated between flap survival and transfusion status (HR = 1.73 IC 95%: 0.5 to 3.96; p = 0.192) (p = 0.192) independently from the number of units transfused, the preoperative diagnosis of anemia, and the type of flap used and did not establish an increased risk of VPT. Conclusions This study did not demonstrate an association between RBCT during preoperative period and the risk for VPT or microvascular free flap survival rate on postoperative follow up.

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