Red Blood Cell Conservation and Use in the Cardiovascular Operating Rooms at Ben Taub General Hospital

被引：0

作者：

Lindgren, Taylor ^{[1
]}

Kodakandla, Harica ^{[1
]}

Caraway, Shelley M. ^{[1
]}

Shah, Krishna B. ^{[1
]}

Huang, Xiaofan ^{[2
]}

Ibekwe, Stephanie Opusunju ^{[1
]}

机构：

[1] Baylor Coll Med, Dept Anesthesiol, Houston, TX 77030 USA

[2] Baylor Coll Med, Houston, TX USA

[3] Ben Taub Gen Hosp, Houston, TX USA

来源：

JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA | 2023年 / 37卷 / 10期

关键词：

blood conservation; quality improvement; transfusion; cardiovascular surgery; cardiopulmonary bypass; CARDIAC-SURGERY; TRANSFUSION; OUTCOMES;

D O I：

10.1053/j.jvca.2023.06.026

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Objectives: A conservative hemoglobin transfusion threshold is noninferior to a liberal threshold in cardiac surgery. However, red blood cell (RBC) transfusion remains common during cardiac surgery. The authors' single-center, retrospective study aimed to decrease RBC transfusions for hemoglobin >7.5 g/dL in nonemergent cardiovascular surgeries utilizing cardiopulmonary bypass (CPB), by educating the anesthesiology and surgical staff on the benefits of a conservative threshold for transfusions, and incorporating the discussion and routine use of blood conservation methods for all nonemergent cardiac surgeries.Design: This was a single-center, retrospective study that included all nonemergent coronary artery bypass grafting and single-valve cases utilizing CPB from January 2018 to December 2021 before and after the intervention in July 2019.Setting: The data involved a single community hospital. Participants: A total of 417 patients were included in the study.Interventions: The authors adopted a conservative threshold for blood transfusion and implemented a collaborative multidisciplinary approach to blood conservation.Measurements and Main Results: Baseline patient characteristics were summarized, and the incidence of RBC transfusion before and after the intervention on July 26, 2019, were compared by Wilcoxon rank sum and chi-square tests. Multivariate logistic regression was used. The inter-vention was significantly associated with reduced RBC transfusion rate after adjusting for confounding variables (p < 0.05). The odds of receiving an RBC transfusion among patients after the intervention was 0.615 times the odds among patients before intervention (95% CI: 0.3913-0.9663).Conclusions: The authors' goal was to improve patient outcomes and the quality of perioperative care during cardiac surgery. By implementing a protocol and educating anesthesiologists, surgeons, and perfusionists, they successfully decreased the incidence of RBC transfusion above a hemoglobin of 7.5 g/dL.(c) 2023 Elsevier Inc. All rights reserved.

引用

页码：1946 / 1950

页数：5

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