Comparison of Two Different Red Blood Cell Transfusion Thresholds on Short-Term Clinical Outcomes of Patients Undergoing Aortic Surgery With Deep Hypothermic Circulatory Arrest

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• 作者：Yongyuan Wang ; BA ; Hongwen Ji ; MD ; ^{jihongwen@hotmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：red blood cell transfusion ; circulatory arrest ; deep hypothermia induced ; aortic surgery
• 刊名：Journal of Cardiothoracic and Vascular Anesthesia
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：30
• 期：5
• 页码：1163-1166
• 全文大小：127 K

文摘

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.

Design

Retrospective, controlled study.

Setting

National Center for Cardiovascular Diseases and a university hospital, Beijing, China.

Participants

The study comprised 74 patients undergoing aortic surgery with DHCA from January 1 to December 31, 2014.

Interventions

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.

Measurements and Main 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.