This paper by David Gerber deals with anemia and transfusion in cardiac surgery patients. It basically lists studies in an unstructured mix of retrospective analyses and controlled trials on the outcome of blood transfusion in, mostly, CABG patients. It is not a true metaanalysis with defined search criteria, criticism of study methods and level of evidence recommendations from the resulting odds ratio.

However, for most outcomes, the majority of retrospective analyses and controlled studies presented appear to concur. In most studies, tolerance of anemia as well as a restrictive transfusion strategy reduced postoperative long-term and short-term mortality; cardiac complications such as atrial fibrillation, ischemic complications and left ventricular dysfunction; pulmonary complications such as respiratory distress, failure and prolonged ventilatory time; postoperative infections, organ system dysfunction (i.e. renal) and improved wound healing and quality of life indicators.

Data on transfusion alternatives are sparse and not as well presented.

– Thomas Frietsch