Faculty Opinions recommendation of Outcomes using a conservative versus liberal red blood cell transfusion strategy in infants requiring cardiac operation.

2016 ◽  
Author(s):  
Davide Cattano
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Transfusion Strategy ◽  
Cardiac Operation

scholarly journals Outcomes Using a Conservative Versus Liberal Red Blood Cell Transfusion Strategy in Infants Requiring Cardiac Operation

2017 ◽  
Vol 103 (1) ◽  
pp. 206-214 ◽  
Author(s):  
Jill M. Cholette ◽  
Michael F. Swartz ◽  
Jeffrey Rubenstein ◽  
Kelly F. Henrichs ◽  
Hongyue Wang ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Transfusion Strategy ◽  
Cardiac Operation

scholarly journals Using arterial-venous oxygen difference to guide red blood cell transfusion strategy

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Alberto Fogagnolo ◽  
Fabio Silvio Taccone ◽  
Jean Louis Vincent ◽  
Giulia Benetto ◽  
Elaine Cavalcante ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Transfusion Strategy ◽  
Oxygen Difference

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?

RED BLOOD CELL TRANSFUSION CAN WORSE ORGAN DIS-FUNCTION AND MORTALITY IN PATIENTS SUBMITTED TO RESTRICTIVE TRANSFUSION STRATEGY.

2006 ◽  
Vol 34 ◽  
pp. A127
Author(s):  
Rafael B Tomita ◽  
Daniele M Torres ◽  
Maria Tereza M Ferrari ◽  
João M Silva ◽  
Paulo Sérgio D Urtado ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Transfusion Strategy ◽  
Restrictive Transfusion ◽  
Restrictive Transfusion Strategy

scholarly journals An Individualized Red Blood Cell Transfusion Strategy Using Pediatric Perioperative-Transfusion-Trigger Score Reduced Perioperative Blood Exposure for Children: A Randomized Controlled Clinical Trial

2021 ◽  
Author(s):  
Zhen Luo ◽  
Yansong Li ◽  
Yunxia Zuo ◽  
Ren Liao ◽  
Jin Liu
Keyword(s):  
Clinical Trial ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Strategy Group ◽  
Transfusion Strategy ◽  
Randomized Controlled ◽  
Registration Number

Abstract Background The optimal red blood cell transfusion strategy in children remains unclear. We developed an individualized pediatric red blood cell transfusion strategy, and postulated that red blood cell transfusion guided by this strategy in children would reduce blood exposure without compromising patients’ safety. Methods In this randomized controlled clinical trial, 99 children undergoing non-cardiac surgeries who had blood loss of more than 20% total blood volume were randomly assigned to an individualized-strategy group using Pediatric Perioperative-Transfusion-Trigger Score, or a control group. The amount of transfused red blood cells was counted, and patients were followed up for postoperative complications by day-30. This trial was registered at the Chinese Clinical Trial Registry (Registration number: ChiCTR-IRP-16007909, Date:07/02/2016). Results 26 children (53.1%) in individualized-strategy group received transfusion perioperatively, as compared with 37 children (74%) in the control group (p<0.05). During surgery, children in individualized-strategy group were exposed to fewer transfusions than in the control group (0.87±1.03 vs. 1.33±1.20 red-blood-cell units per patient, p<0.05). The incidence of severe complications in individualized-strategy group had the lower trend compare to the control group (8.2% vs. 18%, p=0.160). No significant differences were found in the other outcomes. Conclusion This study proved that transfusion guided by the individualized strategy reduced perioperative blood exposure in children, without increasing the incidence of severe complications. This conclusion needs to be further confirmed by implementing multicenter, large-sample clinical trials. Trial registration The study was registered at http://www.chictr.org.cn/showprojen.aspx?proj=13361 (Registration number: ChiCTR-IRP-16007909, Date:07/02/2016).

scholarly journals Restrictive vs. Liberal Red Blood Cell Transfusion Strategy in Patients With Acute Myocardial Infarction and Anemia: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Yeshen Zhang ◽  
Zhengrong Xu ◽  
Yuming Huang ◽  
Qirao Ye ◽  
Nianjin Xie ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Transfusion Strategy ◽  
Restrictive Transfusion ◽  
Liberal Transfusion ◽  
Overall Mortality

Objective: Anemia is frequent in patients with acute myocardial infarction (AMI), and the optimal red blood cell transfusion strategy for AMI patients with anemia is still controversial. We aimed to compare the efficacy of restrictive and liberal red cell transfusion strategies in AMI patients with anemia.Methods: We systematically searched PubMed, EMBASE, Web of Science, Cochrane Library, and Clinicaltrials.gov, from their inception until March 2021. Studies designed to compare the efficacy between restrictive and liberal red blood cell transfusion strategies in patients with AMI were included. The primary outcome was all-cause mortality, including overall mortality, in-hospital or follow-up mortality. Risk ratios (RR) with 95% confidence intervals (CI) were presented and pooled by random-effects models.Results: The search yielded a total of 6,630 participants in six studies. A total of 2,008 patients received restrictive red blood cell transfusion while 4,622 patients were given liberal red blood cell transfusion. No difference was found in overall mortality and follow-up mortality between restrictive and liberal transfusion groups (RR = 1.07, 95% CI = 0.82–1.40, P = 0.62; RR = 0.89, 95% CI = 0.56–1.42, P = 0.62). However, restrictive transfusion tended to have a higher risk of in-hospital mortality compared with liberal transfusion (RR = 1.22, 95% CI = 1.00–1.50, P = 0.05). No secondary outcomes, including follow-up reinfarction, stroke, and acute heart failure, differed significantly between the two groups. In addition, subgroup analysis showed no differences in overall mortality between the two groups based on sample size and design.Conclusion: Restrictive and liberal red blood cell transfusion have a similar effect on overall mortality and follow-up mortality in AMI patients with anemia. However, restrictive transfusion tended to have a higher risk of in-hospital mortality compared with liberal transfusion. The findings suggest that transfusion strategy should be further evaluated in future studies.

Noteworthy Literature Published in 2018 for Cardiothoracic Anesthesiologists

2019 ◽  
Vol 23 (2) ◽  
pp. 148-155 ◽  
Author(s):  
Elizabeth Landry ◽  
Jochen Daniel Muehlschlegel
Keyword(s):  
Cardiopulmonary Bypass ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Red Blood Cell Transfusion ◽  
Left Ventricular Assist Devices ◽  
Transfusion Strategy ◽  
Stroke Incidence ◽  
Arterial Blood

The year 2018 was marked by high-quality, impactful articles spanning the basic, translational, and clinical spectrum in the field of cardiothoracic anesthesia. In this article, we present several hand-picked articles from the past year that we feel were the most significant in shaping our specialty. Large multicenter, randomized controlled trials presenting clinical outcome data dominated the publishing arena: is a restrictive red blood cell transfusion strategy superior to a liberal red blood cell transfusion strategy during cardiopulmonary bypass? Does a low mean arterial blood pressure strategy during cardiopulmonary bypass increase stroke incidence? Does the obesity paradox apply to cardiac surgery? Advancing technology continues to revolutionize our field: can the MitraClip be used to effectively treat secondary mitral regurgitation? Can stem cells improve cardiac function in patients with left ventricular assist devices? These studies allow us to shape our practice in an evidence-based manner, so that we may evolve as a specialty and deliver the best care to our patients.

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