The relationship between total red blood cells and plasma transfusion and acute lung injury risk after cardiac surgery: A retrospective study

The aim of our study was to determine whether red blood cells (RBCs) and fresh frozen plasma (FFP) transfusion is independently associated with the development of acute lung injury (ALI) in patients after cardiac surgery. In retrospective study, 165 patients were included. The results showed total fresh RBCs transfusion were not significantly increased in patients who developed ALI compared with patients who did not develop ALI (4.7 ± 2.4, 4 [0-12] units VS 4.0 ± 1.9, 3 [0-9] units, P = 0.119). FFP transfusion were also not significantly increased (704.1 ± 832.5, 600 [150-6500] ml VS 533.9 ± 323.6, 400 [125-3100] ml, P = 0.053). Multivariable logistic regression analysis showed that only age and CPB time were independent factors for ALI, but not for total RBCs and FFP transfused, with the adjusted OR 0.952 (95% CI 0.762-1.189, P = 0.664), and 1.000 (95% CI 0.999-1.001, P = 0.480), respectively. In subgroup analysis, female patients showed a lower ALI incidence in low RBCs transfused group (23.9% VS 45.0%, OR 0.38, 95% CI 0.15-0.98) and in low FFP transfused group (22.0% VS 44.4%, OR 0.35, 95% CI 0.14-0.90). Our study demonstrates that red blood cells and fresh-frozen plasma transfusion are not related with ALI after cardiac surgery in our institution.