Document Detail


Increased mortality, morbidity, and cost associated with red blood cell transfusion after cardiac surgery.
MedLine Citation:
PMID:  18830077     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Literature since 2006 was reviewed to identify the harms and costs of red blood cell (RBC) transfusion. RECENT FINDINGS: Several studies, in people having various cardiac surgery operations, found strong associations of RBC transfusion with mortality and postoperative morbidity. The effect on mortality was strongest close to the time of operation but extended to 5 years. Morbidity outcomes included serious wound and systemic infections, renal failure, prolonged ventilation, low cardiac index, myocardial infarction, and stroke. RBC transfusion was also strongly associated with increased cardiac intensive care unit and ward postoperative stay, and hence, increased cost of admission; available studies did not consider all resources used and the associated costs. SUMMARY: The harms of RBC transfusion have potentially serious and long-term consequences for patients and are costly for health services. This evidence should shift clinicians' equipoise towards more restrictive transfusion practice. The immediate aim should be to avoid transfusing a small number of RBC units for general malaise attributed to anaemia, a practice that appears to occur in about 50% of transfused patients. Randomized trials comparing restrictive and liberal transfusion triggers are urgently needed to directly compare the benefits and harms from RBC transfusion.
Authors:
Barnaby C Reeves; Gavin J Murphy
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  23     ISSN:  1531-7080     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-02     Completed Date:  2009-03-03     Revised Date:  2009-06-10    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  607-12     Citation Subset:  -    
Affiliation:
Bristol Heart Institute, University of Bristol, Bristol Royal Infirmary, Bristol, UK. barney.reeves@bristol.ac.uk
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Republished from:
Curr Opin Anaesthesiol. 2008 Oct;21(5):669-73   [PMID:  18784497 ]

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