کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2758872 1150142 2016 10 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Intraoperative Anemia and Single Red Blood Cell Transfusion During Cardiac Surgery: An Assessment of Postoperative Outcome Including Patients Refusing Blood Transfusion
ترجمه فارسی عنوان
آنمی درون عمل جراحی و انتقال تنها سلول های قرمز خون در طول جراحی قلب: ارزیابی نتایج پس از عمل، از جمله بیماران مجاز به انتقال خون
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیهوشی و پزشکی درد
چکیده انگلیسی

ObjectivesIncreasing evidence suggests benefits from restrictive red blood cell transfusion (RBC) thresholds in major surgery and critically ill patients. However, these benefits are not obvious in cardiac surgery patients with intraoperative anemia. The authors examined the association between uncorrected hemoglobin (Hb) levels and selected postoperative outcomes as well as the effects of RBCs.DesignCohort study with prospectively collected data from a cardiac surgery registry.SettingA major cardiac surgical hospital within the Netherlands, which is also a referral center for Jehovah’s Witnesses.ParticipantsPatients (23,860) undergoing cardiac surgery between 1997 and 2013.InterventionsComparisons were done in patients with intraoperative nadir Hb<8 g/dL and/or an Hb decrease≥50%. Comparison (A) between Jehovah’s Witnesses (Witnesses) and matched non-Jehovah’s Witnesses (non-Witnesses) transfused with 1 unit of RBC, and comparison (B) between patients given 1 unit of RBC intraoperatively versus matched non-transfused patients.Measurements and Main ResultsPostoperative outcomes were myocardial infarction, renal replacement therapy, stroke, and death. With propensity matching, the authors optimized exchangeability of the compared groups. Adverse outcomes increased with a decreasing Hb both among Witnesses and among non-Witnesses. The incidence of postoperative complications did not differ between Witnesses and matched non-Witnesses who received RBC (adjusted odds ratio 1.44, 95% confidence interval 0.63-3.29). Similarly, postoperative complications did not differ between patients who received a red cell transfusion and matched patients who did not (adjusted odds ratio 0.94, confidence interval 0.72-1.23).ConclusionIntraoperative anemia is associated with adverse outcomes after cardiac surgery, and a single RBC transfusion does not seem to influence these outcomes.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Cardiothoracic and Vascular Anesthesia - Volume 30, Issue 2, April 2016, Pages 363–372
نویسندگان
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