Blood transfusion practices in cardiac anesthesia

Abstract

Objective We have studied the variability of blood transfusion on hemodynamics and its complications during cardiac surgeries at a single center in Egypt. Patients and methods A total of 35 patients of both sexes, with ages from 21 to 70 years, scheduled for open heart surgeries were prospectively enrolled in this observational study between December 2019 and June 2020. Hemodynamic variables, such as mean arterial blood pressure and heart rate were recorded before induction (T1), after endotracheal intubation (T2), immediately before cardiopulmonary bypass (CPB) (T3), 30 min into CPB (T4), 15 min after successful weaning (T5), after sternal closure (T6), and upon arrival in the ICU (T7). The total amount of administered blood and blood products transfused intraoperatively and on the first day postoperatively; the total amount of fluids administered, including the CPB prime volume; and the total intraoperative urine output were recorded. Moreover, the number of patients who needed inotropic support, recovery time, time to extubation in the first 24 h postoperatively, length of ICU stay, and postoperative complication were recorded. Results We found that 68.6% (24 patients) of patients undergoing cardiac surgery received blood and/or blood product transfusion intraoperatively, and 31.4% (11 patients) were not transfused blood, but 14.3% (five patients) of them received blood postoperatively. Moreover, there were significant increases in the numbers of American Sociological Association III patients in blood transfusion group compared with other group, with increased need for inotropic drug and increased postoperative morbidity and mortality. Conclusion Blood transfusion in cardiac surgeries was associated with more incidences of postoperative complication and worse outcomes.