title: Factors influencing the individual effects of blood transfusions on oxygen delivery and oxygen consumption.
abstract: OBJECTIVE
  To determine factors influencing the individual effects of blood transfusions regarding oxygen delivery and consumption.
  
  
  METHODS
  Chart review.
  
  
  METHODS
  A university hospital cardiosurgical intensive care unit.
  
  
  METHODS
  Sixty-seven patients with 170 transfusion events evaluated.
  
  
  METHODS
  Blood transfusion.
  
  
  RESULTS
  Measurements were performed before and after a blood transfusion, separated by 302 +/- 13 mins (mean +/- SEM). The individual increase in cardiac index resulting from a blood transfusion was inversely related to cardiac index before transfusion (p < .001), oxygen delivery index before transfusion (p < .001), and oxygen consumption index before transfusion (p < .001). The individual increase in oxygen delivery index was inversely related to oxygen consumption index before transfusion (p < .001). The individual increase in oxygen consumption index was inversely related to oxygen consumption index before transfusion (p < .001). Individual changes in cardiac index, oxygen delivery index, and oxygen consumption index were not significantly related to preoperative ejection fraction (25%-87%), age (32-81 yrs), and pretransfusion hemoglobin concentration (5.0-11.8 g/dL).
  
  
  CONCLUSIONS
  In adult patients after cardiovascular surgery, oxygen delivery- and oxygen consumption-related variables predict the individual response to blood transfusions better than do patient characteristics such as preoperative ejection fraction, age, and pretransfusion hemoglobin concentration. Including oxygen delivery and oxygen consumption, variables into the transfusion decision, thus, may enable a more individual use of allogeneic blood in specific situations.
authors.affiliation: Institute of Anesthesiology, University Hospital Zürich, University of Zürich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Casutt
authors.forename: B
authors.initials: B
authors.lastname: Seifert
authors.forename: T
authors.initials: T
authors.lastname: Pasch
authors.forename: E R
authors.initials: ER
authors.lastname: Schmid
authors.forename: M I
authors.initials: MI
authors.lastname: Turina
authors.forename: D R
authors.initials: DR
authors.lastname: Spahn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D002318:Cardiovascular Diseases / Q000601:surgery; D003325:Coronary Care Units; D006439:Hemodynamics; D006454:Hemoglobins / Q000378:metabolism; D006785:Hospitals, University; D006801:Humans; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies
chemical_list: D006454:Hemoglobins; D010100:Oxygen