Dose-Dependent Effects of Intraoperative Low Volume Red Blood Cell Transfusions on Postoperative Outcomes in Cardiac Surgery Patients
Objective To determine the incremental risk associated with each intraoperative red blood cell transfusion in cardiac surgery patients. Design Retrospective analysis on prospectively collected data. Setting Single tertiary care hospital. Participants Seven hundred forty-five patients undergoing on-p...
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| Veröffentlicht in: | Journal of cardiothoracic and vascular anesthesia 2014-12, Vol.28 (6), p.1545-1549 |
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| container_title | Journal of cardiothoracic and vascular anesthesia |
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| creator | Yu, Pey-Jen, MD Cassiere, Hugh A., MD Dellis, Sophia L., MS Esposito, Rick A., MD Kohn, Nina, MA LaConti, Donna, BS Hartman, Alan R., MD |
| description | Objective To determine the incremental risk associated with each intraoperative red blood cell transfusion in cardiac surgery patients. Design Retrospective analysis on prospectively collected data. Setting Single tertiary care hospital. Participants Seven hundred forty-five patients undergoing on-pump cardiac surgery between January 2010 and June 2012 who received between 1 and 3 units of red blood cell transfusion intraoperatively. Interventions All patients received between 1 and 3 units of red blood cell transfusions. All transfusions were with leukoreduced blood that had been stored for |
| doi_str_mv | 10.1053/j.jvca.2014.05.025 |
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Design Retrospective analysis on prospectively collected data. Setting Single tertiary care hospital. Participants Seven hundred forty-five patients undergoing on-pump cardiac surgery between January 2010 and June 2012 who received between 1 and 3 units of red blood cell transfusion intraoperatively. Interventions All patients received between 1 and 3 units of red blood cell transfusions. All transfusions were with leukoreduced blood that had been stored for<14 days. Measurements and Main Results Postoperative complications and length of intubation were associated with the number of red blood cell units transfused. Transfusion of each additional unit of red blood cells was associated with incrementally worse outcomes. Median length of intubation was 11 hours, 12 hours, and 13 hours in patients receiving 1, 2, and 3 units of red blood cell transfusions, respectively (p<0.005). Similarly, each additional unit of red blood cell transfusion was associated with increasing postoperative septicemia (0% v 0.35% v 2.29%, p<0.006) and postoperative pneumonia (0% v 0.70% v 2.29%, p<0.013). Conclusions There is a step-wise increase in length of postoperative intubation with each red blood cell transfusion in patients undergoing cardiac surgery. Each additional unit of intraoperative RBC transfusion also may increase postoperative infectious complications. Thus, even single-unit reductions in red blood cell transfusions may have significant impact on outcomes.</description><identifier>ISSN: 1053-0770</identifier><identifier>EISSN: 1532-8422</identifier><identifier>DOI: 10.1053/j.jvca.2014.05.025</identifier><identifier>PMID: 25263773</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Anesthesia & Perioperative Care ; blood transfusion ; cardiac surgery ; Cardiac Surgical Procedures ; Critical Care ; Erythrocyte Transfusion - methods ; Female ; Humans ; Intraoperative Care - methods ; Intubation, Intratracheal - methods ; Intubation, Intratracheal - statistics & numerical data ; Length of Stay - statistics & numerical data ; Male ; morbidity ; New York - epidemiology ; outcomes ; postoperative complications ; Postoperative Complications - epidemiology ; Retrospective Studies ; Risk ; Time Factors ; Treatment Outcome</subject><ispartof>Journal of cardiothoracic and vascular anesthesia, 2014-12, Vol.28 (6), p.1545-1549</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-95263ec8adaed2e8a588adb5c36f75b4a38d45103c96df9d41e1e85c622fb6e43</citedby><cites>FETCH-LOGICAL-c411t-95263ec8adaed2e8a588adb5c36f75b4a38d45103c96df9d41e1e85c622fb6e43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.jvca.2014.05.025$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3541,27915,27916,45986</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25263773$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yu, Pey-Jen, MD</creatorcontrib><creatorcontrib>Cassiere, Hugh A., MD</creatorcontrib><creatorcontrib>Dellis, Sophia L., MS</creatorcontrib><creatorcontrib>Esposito, Rick A., MD</creatorcontrib><creatorcontrib>Kohn, Nina, MA</creatorcontrib><creatorcontrib>LaConti, Donna, BS</creatorcontrib><creatorcontrib>Hartman, Alan R., MD</creatorcontrib><title>Dose-Dependent Effects of Intraoperative Low Volume Red Blood Cell Transfusions on Postoperative Outcomes in Cardiac Surgery Patients</title><title>Journal of cardiothoracic and vascular anesthesia</title><addtitle>J Cardiothorac Vasc Anesth</addtitle><description>Objective To determine the incremental risk associated with each intraoperative red blood cell transfusion in cardiac surgery patients. Design Retrospective analysis on prospectively collected data. Setting Single tertiary care hospital. Participants Seven hundred forty-five patients undergoing on-pump cardiac surgery between January 2010 and June 2012 who received between 1 and 3 units of red blood cell transfusion intraoperatively. Interventions All patients received between 1 and 3 units of red blood cell transfusions. All transfusions were with leukoreduced blood that had been stored for<14 days. Measurements and Main Results Postoperative complications and length of intubation were associated with the number of red blood cell units transfused. Transfusion of each additional unit of red blood cells was associated with incrementally worse outcomes. Median length of intubation was 11 hours, 12 hours, and 13 hours in patients receiving 1, 2, and 3 units of red blood cell transfusions, respectively (p<0.005). Similarly, each additional unit of red blood cell transfusion was associated with increasing postoperative septicemia (0% v 0.35% v 2.29%, p<0.006) and postoperative pneumonia (0% v 0.70% v 2.29%, p<0.013). Conclusions There is a step-wise increase in length of postoperative intubation with each red blood cell transfusion in patients undergoing cardiac surgery. Each additional unit of intraoperative RBC transfusion also may increase postoperative infectious complications. Thus, even single-unit reductions in red blood cell transfusions may have significant impact on outcomes.</description><subject>Aged</subject><subject>Anesthesia & Perioperative Care</subject><subject>blood transfusion</subject><subject>cardiac surgery</subject><subject>Cardiac Surgical Procedures</subject><subject>Critical Care</subject><subject>Erythrocyte Transfusion - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Intraoperative Care - methods</subject><subject>Intubation, Intratracheal - methods</subject><subject>Intubation, Intratracheal - statistics & numerical data</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>morbidity</subject><subject>New York - epidemiology</subject><subject>outcomes</subject><subject>postoperative complications</subject><subject>Postoperative Complications - epidemiology</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1053-0770</issn><issn>1532-8422</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctu1DAUhi0EoqXwAiyQl2wSfE0yEkKC6YVKI7Wiha3lsY-RQ2IPdjJoHoD3xtEUkFiw8ll8_2-fzwi9pKSmRPI3fd3vja4ZoaImsiZMPkKnVHJWdYKxx2UuVEXalpygZzn3hFAqZfsUnTDJGt62_BT9PI8ZqnPYQbAQJnzhHJgp4-jwdZiSjjtIevJ7wJv4A3-JwzwC_gQWfxhitHgNw4Dvkw7ZzdnHUIIB38Y8_c3dzJOJI2TsA17rZL02-G5OXyEd8G1Byq35OXri9JDhxcN5hj5fXtyvP1abm6vr9ftNZQSlU7Vang2m01aDZdBp2ZV5Kw1vXCu3QvPOCkkJN6vGupUVFCh00jSMuW0Dgp-h18feXYrfZ8iTGn02ZQcdIM5Z0YYL1hFCuoKyI2pSzDmBU7vkR50OihK1iFW9WvSrRb8iUhX9JfTqoX_ejmD_RH77LsDbIwBly72HpLIpBgxYn4p3ZaP_f_-7f-Jm8MEbPXyDA-Q-zikUf4qqzBRRd0vP8v9UEMJatuK_AE6XrU0</recordid><startdate>20141201</startdate><enddate>20141201</enddate><creator>Yu, Pey-Jen, MD</creator><creator>Cassiere, Hugh A., MD</creator><creator>Dellis, Sophia L., MS</creator><creator>Esposito, Rick A., MD</creator><creator>Kohn, Nina, MA</creator><creator>LaConti, Donna, BS</creator><creator>Hartman, Alan R., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20141201</creationdate><title>Dose-Dependent Effects of Intraoperative Low Volume Red Blood Cell Transfusions on Postoperative Outcomes in Cardiac Surgery Patients</title><author>Yu, Pey-Jen, MD ; Cassiere, Hugh A., MD ; Dellis, Sophia L., MS ; Esposito, Rick A., MD ; Kohn, Nina, MA ; LaConti, Donna, BS ; Hartman, Alan R., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-95263ec8adaed2e8a588adb5c36f75b4a38d45103c96df9d41e1e85c622fb6e43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Anesthesia & Perioperative Care</topic><topic>blood transfusion</topic><topic>cardiac surgery</topic><topic>Cardiac Surgical Procedures</topic><topic>Critical Care</topic><topic>Erythrocyte Transfusion - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Intraoperative Care - methods</topic><topic>Intubation, Intratracheal - methods</topic><topic>Intubation, Intratracheal - statistics & numerical data</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>morbidity</topic><topic>New York - epidemiology</topic><topic>outcomes</topic><topic>postoperative complications</topic><topic>Postoperative Complications - epidemiology</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yu, Pey-Jen, MD</creatorcontrib><creatorcontrib>Cassiere, Hugh A., MD</creatorcontrib><creatorcontrib>Dellis, Sophia L., MS</creatorcontrib><creatorcontrib>Esposito, Rick A., MD</creatorcontrib><creatorcontrib>Kohn, Nina, MA</creatorcontrib><creatorcontrib>LaConti, Donna, BS</creatorcontrib><creatorcontrib>Hartman, Alan R., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yu, Pey-Jen, MD</au><au>Cassiere, Hugh A., MD</au><au>Dellis, Sophia L., MS</au><au>Esposito, Rick A., MD</au><au>Kohn, Nina, MA</au><au>LaConti, Donna, BS</au><au>Hartman, Alan R., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dose-Dependent Effects of Intraoperative Low Volume Red Blood Cell Transfusions on Postoperative Outcomes in Cardiac Surgery Patients</atitle><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle><addtitle>J Cardiothorac Vasc Anesth</addtitle><date>2014-12-01</date><risdate>2014</risdate><volume>28</volume><issue>6</issue><spage>1545</spage><epage>1549</epage><pages>1545-1549</pages><issn>1053-0770</issn><eissn>1532-8422</eissn><abstract>Objective To determine the incremental risk associated with each intraoperative red blood cell transfusion in cardiac surgery patients. Design Retrospective analysis on prospectively collected data. Setting Single tertiary care hospital. Participants Seven hundred forty-five patients undergoing on-pump cardiac surgery between January 2010 and June 2012 who received between 1 and 3 units of red blood cell transfusion intraoperatively. Interventions All patients received between 1 and 3 units of red blood cell transfusions. All transfusions were with leukoreduced blood that had been stored for<14 days. Measurements and Main Results Postoperative complications and length of intubation were associated with the number of red blood cell units transfused. Transfusion of each additional unit of red blood cells was associated with incrementally worse outcomes. Median length of intubation was 11 hours, 12 hours, and 13 hours in patients receiving 1, 2, and 3 units of red blood cell transfusions, respectively (p<0.005). Similarly, each additional unit of red blood cell transfusion was associated with increasing postoperative septicemia (0% v 0.35% v 2.29%, p<0.006) and postoperative pneumonia (0% v 0.70% v 2.29%, p<0.013). Conclusions There is a step-wise increase in length of postoperative intubation with each red blood cell transfusion in patients undergoing cardiac surgery. Each additional unit of intraoperative RBC transfusion also may increase postoperative infectious complications. Thus, even single-unit reductions in red blood cell transfusions may have significant impact on outcomes.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25263773</pmid><doi>10.1053/j.jvca.2014.05.025</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Anesthesia & Perioperative Care blood transfusion cardiac surgery Cardiac Surgical Procedures Critical Care Erythrocyte Transfusion - methods Female Humans Intraoperative Care - methods Intubation, Intratracheal - methods Intubation, Intratracheal - statistics & numerical data Length of Stay - statistics & numerical data Male morbidity New York - epidemiology outcomes postoperative complications Postoperative Complications - epidemiology Retrospective Studies Risk Time Factors Treatment Outcome |
| title | Dose-Dependent Effects of Intraoperative Low Volume Red Blood Cell Transfusions on Postoperative Outcomes in Cardiac Surgery Patients |
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