title: Blood transfusion practice in a referral cardiovascular center in tehran, iran: a critical point of view.
abstract: BACKGROUND
  Unnecessary perioperative transfusions are likely to be related to increased morbidity and additional costs in cardiac surgery.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the blood transfusion practice during and after adult cardiac surgery in a referral university hospital in Iran.
  
  
  METHODS
  In a descriptive study, we collected data from 153 adult patients underwent cardiac surgery at Rajaie Cardiovascular Medical and Research Center, Tehran, Iran from January to March 2013. The variables were patients' demographic, operative and post-operative data and the numbers of transfused packed red blood cell (PC) units and fresh frozen plasma (FFP) during and after cardiac surgery. Then we evaluated patients' and physicians' related causes of relatively increased transfusion rate in our patients and compared them with literature.
  
  
  RESULTS
  Of 153 patients, 96.8% received PC and 54.9% transfused FFP during or after surgery. Most of the transfusions were done after operation in intensive care unit (ICU). Also, 20% and 17% of the patients underwent transfusion of more than 6 units of PC and FFP, respectively. The mean left ventricular ejection fraction of the patients was 42.5 ± 10.9%. A significant number of patients had anemia (especially women) or received anticoagulants or antiplatelet agents preoperatively. Thirteen percent of the patients underwent emergency operations and 12.3% had re-exploration.
  
  
  CONCLUSIONS
  The results of this study demonstrate that the cardiac surgery patients receive a relatively greater number of PC or FFP units during and after the operation in our center. This finding may be explained to some extent by the fact that the sicker and more co-morbid patients referred to our center and such patients are more anemic and undergoing more emergent and complex procedures. Moreover, Transfusion strategy or protocol should be updated, especially after the operation in ICU.
authors.affiliation: Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Alizadeh-Ghavidel
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Ziae
authors.initials: Z
authors.lastname: Totonchi
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Abedin
authors.initials: A
authors.lastname: Hoseini
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ziyaeifard
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Rasoul
authors.initials: R
authors.lastname: Azarfarin
keywords: Blood Transfusion; Cardiac Surgical Procedures; Fresh Frozen Plasma; Practice Guideline