Abstract
BackgroundIn our institution, we have redefined our criteria for direct availability of red blood cell (RBC) units in the operation room. In this study, we sought to evaluate the safety of applying this new logistical policy of blood transfusion in the first preliminary group of patients.MethodsIn March 2010, we started a new policy concerning the elective availability of RBC units in the operation room. This policy was called: No Elective Red Cells (NERC) program. The program was applied for patients undergoing primary isolated coronary artery bypass grafting (CABG) or single valve surgery. No elective RBC units were preoperatively ordered for these patients. In case of urgent need, blood was delivered to the operating room within 20 min. The present study includes the first 500 patients who were managed according to this policy. Logistic regression analyses were performed to investigate the impact of biomedical variables on fulfilling this NERC program.ResultsThe majority of patients (n = 409, 81 %) did not receive any RBCs during the hospital stay. In patients who did receive RBCs (n = 91, 19 %), 11 patients (2.2 %) received RBCs after 24 h postoperatively. Female gender, left ventricular ejection fraction (LVEF) and EuroSCORE were significant predictors for the need of blood transfusion (OR = 3.12; 2.79; 1.17 respectively).ConclusionIn a selected group of patients, it is safe to perform cardiac surgery without the immediate availability of RBCs in the operating room. Transfusion was avoided in 81 % of these patients. Female gender, LVEF and EuroSCORE were associated with blood transfusion.
Highlights
Perioperative transfusion of red blood cells (RBCs) has been associated with increased mortality, morbidity, costs and decreased long-term survival after cardiac surgery [1, 2]
In an earlier report [4], we identified the independent, patient-related risk factors of RBC transfusion after coronary artery bypass grafting (CABG)
Identification of these risk factors led us to follow a new policy concerning the direct availability of packed RBCs in the operating theatre
Summary
Perioperative transfusion of red blood cells (RBCs) has been associated with increased mortality, morbidity, costs and decreased long-term survival after cardiac surgery [1, 2]. In an earlier report [4], we identified the independent, patient-related risk factors of RBC transfusion after coronary artery bypass grafting (CABG). Identification of these risk factors led us to follow a new policy concerning the direct availability of packed RBCs in the operating theatre. Methods In March 2010, we started a new policy concerning the elective availability of RBC units in the operation room. This policy was called: No Elective Red Cells (NERC) program. Logistic regression analyses were performed to investigate the impact of biomedical variables on fulfilling this NERC program
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