Meta-analysis on the influence of perioperative blood transfusion strategies on prognosis of adult patients undergoing cardiac surgery

Abstract

Objective Using meta-analysis method to compare the effect of liberal and restrictive transfusion strategies on the prognosis of adult patients undergoing cardiac surgery, and to provide evidence for evidence-based medicine. Methods By using the Cochrane system evaluation method, the database of Chinese and foreign countries, Chinese biomedical literature database, Chinese journal full-text database and so on were searched by computer. To search the literature from 1970 to 2018, and to collect clinical randomized controlled trials on blood transfusion strategy and prognosis in adult patients undergoing cardiac surgery. According to the evaluation method of Cochrane system, the effective data extracted is analyzed by meta with RevMan5.3 software. Results A total of 2 863 patients were included in 9 studies. Meta-analysis results showed that the death toll on 30 days after operation(RR value: 1.02, 95%CI: 0.79-1.32, I2=2%, P=0.86), acute renal damage, infection, acute renal injury, pulmonary complications and hospital stay time were no statistical difference, but ICU retention time(RR value: -33.35, 95%CI: -61.7-1.01, I2=38%, P=0.04)in the restrictive transfusion policy group was significantly lower than that of liberal blood transfusion strategy group. Conclusion The use of liberal or restrictive blood transfusion strategy in adult cardiac surgery has no significant impact on the prognosis and complications, but it can reduce the retention time of ICU after operation and significantly reduce the use of blood products and medical costs. Key words: Cardiac surgery; Liberal and restrictive blood transfusion; Complications; Perioperative period; Meta-analysis