Rationalizing blood transfusion in cardiac surgery: preliminary findings with a red cell volume-based model.
OBJECTIVE
Cardiac surgery, utilizing extracorporeal circulation, is associated with a heavy fluid load that may significantly depress haemoglobin concentration. Thus, considering haemoglobin alone may be an inaccurate method of replacing red cell volume loss. This study was designed to examine the impact on red cell transfusion of a red cell volume-based guideline.


METHODS
Patients were randomized to receive red cells as dictated by the red cell volume-based guideline or a haemoglobin-based protocol. End-points considered were red cell transfusion and clinical outcome.


RESULTS
Patients transfused as per the red cell volume-based guideline received significantly less red cells with no associated difference in clinical outcome.


CONCLUSIONS
Considering haemoglobin concentration alone may significantly overestimate the requirement for red cell transfusion in elective cardiac surgery patients.
Slight
R D
RD
The Royal Infirmary of Edinburgh, Little France Crescent, Old Dalkeith Road, Edinburgh, Scotland, UK. rdslight@gmail.com
Fung
A K Y
AK
Alonzi
C
C
Bappu
N J
NJ
McClelland
D B L
DB
Mankad
P S
PS
D000368:Aged; D000465:Algorithms; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D003657:Decision Making; D017558:Elective Surgical Procedures; D017707:Erythrocyte Transfusion; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic
D006454:Hemoglobins