Reducing the immediate availability of red blood cells in cardiac surgery, a single centre experience

Haanschoten, M. C., van Straten, A. H. M., Verstappen, F., van de Kerkhof, D., van Zundert, A. A. J. and Soliman Hamad, M. A. (2015) Reducing the immediate availability of red blood cells in cardiac surgery, a single centre experience. Netherlands Heart Journal, 23 1: 28-32. doi:10.1007/s12471-014-0618-9


Author Haanschoten, M. C.
van Straten, A. H. M.
Verstappen, F.
van de Kerkhof, D.
van Zundert, A. A. J.
Soliman Hamad, M. A.
Title Reducing the immediate availability of red blood cells in cardiac surgery, a single centre experience
Journal name Netherlands Heart Journal   Check publisher's open access policy
ISSN 1568-5888
1876-6250
Publication date 2015-01
Year available 2014
Sub-type Article (original research)
DOI 10.1007/s12471-014-0618-9
Open Access Status
Volume 23
Issue 1
Start page 28
End page 32
Total pages 5
Place of publication Houten, Netherlands
Publisher Bohn Stafleu van Loghum
Collection year 2015
Language eng
Formatted abstract
Background In 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.

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. 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.

Results The 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).

Conclusion In 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.
Keyword Cardiac surgery
Red blood cells
Transfusion
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Published online: 18 October 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
Official Audit
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Created: Thu, 16 Apr 2015, 09:14:37 EST by Andre Van Zundert on behalf of Anaesthesiology and Critical Care - RBWH