Indications for blood transfusion in cardiac surgery.
In addition to its life-saving effect in hemorrhagic shock, transfusion of allogenic packed red blood cells can be beneficial in situations where a critically low hematocrit is contributing to a state of oxygen-supply dependency. These benefits are countered by the risks of transfusion-associated lung injury, transfusion-associated immunomodulation, and cellular hypoxia after RBC transfusion. The critical hematocrit is patient and organ specific, and varies intraoperatively according to the duration and temperature of bypass, as well as for a variable postoperative period. Future randomized studies must prospectively evaluate regional indicators of tissue oxygenation in transfusion algorithms.
Murphy
Gavin J
GJ
Bristol Heart Institute, University of Bristol, Bristol Royal Infirmary, Bristol, United Kingdom. gavinmurphy@bristol.ac.uk
Angelini
Gianni D
GD
D000328:Adult; D000740:Anemia / Q000150:complications; D006348:Cardiac Surgical Procedures; D015687:Cell Hypoxia; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D006454:Hemoglobins / Q000032:analysis; D006801:Humans
D006454:Hemoglobins