Document Detail


Effect of WBC reduction of transfused RBCs on postoperative infection rates in cardiac surgery.
MedLine Citation:
PMID:  12430668     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: WBC-replete blood transfusion has been suggested as an independent cause of increased postoperative infection. STUDY DESIGN AND METHODS: A total of 597 patients undergoing elective coronary artery or heart valve surgery were randomly assigned to receive plasma-reduced (PR), buffy coat-depleted (BCD), or WBC-filtered (WCF) RBCs in the event of requiring blood transfusion. Details of postoperative course were recorded. Further information was collected from the patient's general practitioner 3 months after discharge. RESULTS: No significant difference in inpatient infection rates was observed among patients randomly assigned to receive PR, BCD, or WCF RBCs. When only those receiving transfusion were analyzed (n = 509), use of PR RBCs was associated with more events coded as infections (p < or = 0.05) compared with BCD or WCF RBCs. However, when events coded as urinary tract infections were excluded, there was no significant difference among the three groups. Follow-up performed after discharge showed no difference in readmission rates, but a higher reported rate of infection in those randomly assigned to receive WCF RBCs (p < 0.02). CONCLUSION: No evidence has been found, analyzed by intention to treat, that use of WBC-reduced, BCD, or WCF RBCs reduces postoperative inpatient infection in patients undergoing cardiac bypass surgery.
Authors:
J P Wallis; C E Chapman; K E Orr; S C Clark; J R Forty
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transfusion     Volume:  42     ISSN:  0041-1132     ISO Abbreviation:  Transfusion     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-11-14     Completed Date:  2002-12-04     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1127-34     Citation Subset:  IM    
Affiliation:
Department of Haematology, Freeman Hospital, High Heaton, Newcastle upon Tyne, United Kingdom. jonathan.wallis@tfh.nuth.northy.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Group Incompatibility
Cardiac Surgical Procedures*
Chemical Precipitation
Coronary Artery Bypass*
Cross Infection / epidemiology*,  etiology
England / epidemiology
Erythrocyte Transfusion / adverse effects,  methods*
Female
Filtration
Follow-Up Studies
Humans
Incidence
Leukocytes*
Male
Medical Errors
Middle Aged
Plasma
Postoperative Complications / epidemiology*,  etiology
Risk Factors
Surgical Procedures, Elective
Urinary Tract Infections / epidemiology,  etiology
Comments/Corrections
Comment In:
Transfusion. 2002 Sep;42(9):1106-10   [PMID:  12430664 ]

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