Dose-dependent effects of intraoperative low volume red blood cell transfusions on postoperative outcomes in cardiac surgery patients.

Yu PJ, Cassiere HA, Dellis SL, et al.
J Cardiothorac Vasc Anesth 2014;28:1545-1549.
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Review by : S. Kozek-Langenecker
NATA Review

The authors retrospectively assessed the impact of intraoperative transfusion of 1 to 3 units of red blood cell concentrates (leukodepleted and stored <14 days) on patient outcome after cardiac surgery. Transfusion was administered using a fixed haemoglobin trigger of <8.0 g/dL. Ventilation time, infections, and renal failure increased with incremental transfusions. This paper confirms that blood transfusions increase morbidity and resource use, and encourages single-unit reductions. Guidelines from the European Society of Anaesthesiology may help implement bundles for prompt correction of coagulopathic bleeding, thus leading to decreased transfusion requirements. – Sibylle Kozek-Langenecker
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