Late-Breaking Science Abstracts From the American Heart Association's Scientific Sessions 2017 and Late-Breaking Abstracts in Resuscitation Science From the Resuscitation Science Symposium 2017.

Abstract

### CABG and EP Peri-procedural Dilemmas #### 21574 #### TRiCS III - An International Multicenter Randomized Trial of Transfusion Requirements in Cardiac Surgery C. David Mazer1, Richard P Whitlock2, Dean A Fergusson3, Kevin E Thorpe4, Nadine Shehata5, TRICS III Investigators, Perioperative Anesthesia Clinical Trials Network; 1Anesthesia, St Michaels Hosp, Univ of Toronto, Toronto, Canada, 2Div of Cardiac Surgery and Dept of of Clinical Epidemiology and Biostatistics, Population Health Rsch Institute, McMaster Univ, Hamilton, Canada, 3Depts of Medicine, Surgery, & the Sch of Epidemiology, Public Health and Preventive Medicine, Ottawa Hosp Rsch Institute, Univ of Ottawa, Ottawa, Canada, 4Biostatistics, Applied Health Rsch Cntr and Dalla Lana Sch of Public Health, St. Michael’s Hosp, Univ of Toronto, Toronto, Canada, 5Depts of Medicine, Institute of Health Policy Management and Evaluation, Mount Sinai Hosp, Univ of Toronto, Toronto, Canada. Introduction: There is a critical need to determine the appropriate threshold for red cell transfusion in patients undergoing cardiac surgery since perioperative anemia and allogeneic red blood cell transfusions are both independent predictors of morbidity and mortality. In addition, there is considerable inter-physician and inter-hospital variability in transfusion practice. While restrictive transfusion strategies have been shown to reduce transfusion, their clinical effectiveness and safety in cardiac surgery are not known. Methods: TRICS III is a multicenter randomized controlled trial to evaluate the non-inferiority of a restrictive transfusion strategy compared to a liberal transfusion strategy in cardiac surgery patients with a preoperative European System for Cardiac Operative Risk Evaluation (additive EuroSCORE I) of ≥6 (NCT02042898). Patients were randomized to a “restrictive” strategy (transfusion if hemoglobin <7.5 g/dL intraoperatively and postoperatively) or a “liberal” strategy (transfusion if hemoglobin <9.5 g/dL in the operating room or ICU, and <8.5 g/dL on the ward). The primary outcome is a composite of in hospital death, myocardial infarction, stroke or new renal failure requiring dialysis. Secondary outcomes include duration …