title: Comparison of Two Different Red Blood Cell Transfusion Thresholds on Short-Term Clinical Outcomes of Patients Undergoing Aortic Surgery With Deep Hypothermic Circulatory Arrest.
abstract: OBJECTIVE
  Patients undergoing aortic surgery with deep hypothermic circulatory arrest (DHCA) usually are associated with a high rate of allogeneic blood transfusion, and their red blood cell (RBC) transfusion threshold is unclear and controversial. The purpose of this study was to explore whether a restrictive transfusion threshold was as effective as a liberal transfusion threshold for patients undergoing aortic surgery with DHCA.
  
  
  METHODS
  Retrospective, controlled study.
  
  
  METHODS
  National Center for Cardiovascular Diseases and a university hospital, Beijing, China.
  
  
  METHODS
  The study comprised 74 patients undergoing aortic surgery with DHCA from January 1 to December 31, 2014.
  
  
  METHODS
  Patients were divided retrospectively into the following 2 groups according to the RBC transfusion thresholds-the restrictive group received allogeneic RBC transfusion if the hemoglobin (Hb) level of the patient fell below 8 g/dL during the surgery, and in the liberal group the hemoglobin threshold for allogeneic transfusion was 10 g/dL.
  
  
  RESULTS
  Data on patient demographics, procedure characteristics, allogeneic blood use, and postoperational morbidity and mortality were collected and analyzed. In total, the restrictive group required fewer perioperative transfusions of RBCs (3.9±4.8 v 8.5±6.9 units, p = 0.001) and platelets (1.9±0.8 v 2.6±1.0 units, p = 0.003) compared with the liberal group. Postoperative mortality and complications, including 30-day mortality and bleeding requiring re-exploration, did not differ significantly between the 2 groups.
  
  
  CONCLUSIONS
  For patients undergoing aortic surgery with DHCA, a restrictive RBC transfusion threshold (Hb<8 g per deciliter) may be as effective as a liberal RBC transfusion threshold (Hb<10 g per deciliter) during the surgery, with similar short-term clinical outcomes and less allogeneic transfusion.
authors.affiliation: Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Yongyuan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China. Electronic address: jihongwen@hotmail.com.
authors.forename: Hongwen
authors.initials: H
authors.lastname: Ji
mesh_terms: D000328:Adult; D001011:Aorta / Q000601:surgery*; D002681:China; D050792:Circulatory Arrest, Deep Hypothermia Induced; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: aortic surgery; circulatory arrest; deep hypothermia induced; red blood cell transfusion