Transfusion Policies for Cardiac Surgery Vary in U.S.

Outcomes of transfusion at hematocrit of 30 percent not better than at hematocrit of 24 percent
By Lindsey Marcellin
HealthDay Reporter

TUESDAY, Oct. 12 (HealthDay News) -- Transfusion practices vary widely among institutions providing cardiac surgery, but a restrictive perioperative transfusion status does not appear to be inferior to a more liberal transfusion strategy in terms of 30-day morbidity and mortality, according to two studies published in the Oct. 13 issue of The Journal of the American Medical Association.

Ludhmila A. Hajjar, M.D., Ph.D., of the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo in Brazil, and colleagues conducted a prospective, randomized, controlled clinical noninferiority trial of a restrictive blood transfusion policy (to maintain a hematocrit of 24 percent or greater) compared with a liberal transfusion policy (to maintain a hematocrit of 30 percent or greater). The researchers found no significant difference in 30-day all-cause mortality and severe morbidity between the two groups; however, the number of transfused red blood cell units was an independent risk factor for an adverse outcome at 30 days.

Elliott Bennett-Guerrero, M.D., of Duke University Medical Center in Durham, N.C., and colleagues conducted a study of blood and blood-product transfusion practices for coronary artery bypass graft surgeries and the differences in these transfusion practices among U.S. hospitals. Transfusion practices varied based on three hospital characteristics -- geographic location, academic status, and hospital volume -- but these combined factors accounted for only a very small percentage of the variation in hospital risk-adjusted red blood cell usage. Hospital transfusion rates were not significantly associated with all-cause mortality.

"The influence of attending surgeons' attitudes has been documented," write the authors of an accompanying editorial. "When evaluating a hemoglobin level, treating physicians must resist the temptation to 'first do something' and temper this temptation with a philosophy of 'first do no harm' to achieve the optimal balance of providing the best risk-benefit and cost-effective outcomes of transfusion therapy for patients."

An author of the second study is a named inventor on a patent application related to methods of washing red blood cells.

Abstract - Hajjar
Full Text (subscription or payment may be required)
Abstract - Bennett-Guerrero
Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Copyright © 2010 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles

Blunt Chest Trauma
Journal of Trauma Nursing, November/December 2014
Expires: 12/31/2016 CE:2 $21.95

The School Age Child with Congenital Heart Disease
MCN, The American Journal of Maternal/Child Nursing, January/February 2015
Expires: 2/28/2017 CE:2.5 $24.95

Understanding multiple myeloma
Nursing Made Incredibly Easy!, January/February 2015
Expires: 2/28/2017 CE:2 $21.95

More CE Articles

Subscribe to Recommended CE

Recommended Nursing Articles

Comprehensive Care: Looking Beyond the Presenting Problem
Journal of Christian Nursing, January/March 2015
Free access will expire on March 2, 2015.

Pain and Alzheimer dementia: A largely unrecognized problem
Nursing Made Incredibly Easy!, January/February 2015
Free access will expire on February 16, 2015.

Glycemic control in hospitalized patients
Nursing2015 Critical Care, January 2015
Free access will expire on February 16, 2015.

More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events