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TRANSFUSION PRACTICES

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The rationale for perioperative red blood cell (RBC) transfusion is based on the observations that anemia is an independent risk factor for morbidity and mortality after cardiac surgery and that red blood cell transfusion would benefit a subset of patients presenting tissue hypoperfusion . However, transfusions have been associated with high rates of morbidity and mortality in critically ill patients, and there is increasing evidence for independent relationships between RBC transfusion and infectious complications, cardiac and respiratory morbidity, prolonged length of stay (LOS) and mortality after cardiac surgery.
                                    The Transfusion Requirements After Cardiac Surgery (TRACS) study was a prospective, randomized, controlled trial that recently demonstrated the safety of a restrictive strategy of transfusion compared with a liberal strategy in patients undergoing elective cardiac surgery. In this study, independent of the adopted transfusion strategy, the number of transfused RBC units was an independent risk factor for clinical complications and death at 30 days .
                                    The primary objective of this study was to assess the relationship between RBC transfusion and hospital length of stay in a large, single reference center of cardiac surgery. Secondary objectives were to compare the characteristics of patients who received RBC transfusion with those who did not, to evaluate the relationship of the number of transfused RBC units with mortality and clinical complications, and to identify the predictive factors for a prolonged hospital LOS. We hypothesized that patients requiring early postoperative blood transfusion would have longer hospital length of stay.
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