Increased Demand for Blood Transfusion in Cardiac Surgery, Simple but Unsolved Common Problem

Background: Despite the general concern about the safety of bloodtransfusion and mounting evidence exist for more restrictive practice; there isno national consensus guideline and uniformity of institutions for bloodtransfusion associated with coronary artery bypass graft surgery in Iran. Theaim of this study is an assessment of current transfusion practice andcompares it with one decade ago.Materials and Methods: The authors retrospectively analyzed the data of allpatients undergoing elective surgery (first time operation) during one year, intwo different decade interval (2003 and 2015) in a tertiary heart center.Results: A total of 801 patients were evaluated and compared (n=249 in2015, n=552 in 2003). There is a significant increase in the use of bloodtransfusion in both operating room and at ICU than the last decade (60.6%vs. 42.4%, p<0.001, and 54.4% vs. 39.9%, p <0.001, respectively). Theincidence of preoperative anemia was four times higher in patients whoreceived transfusion, compared to those who did not, in both groups. Withcompared to the past, the patients are older, have less preoperativehematocrit, more diabetic, more need to intra-aortic balloon pump, shorteroperation time, and less postoperative bleeding.Conclusion: With advanced knowledge about transfusion complications andconservative approach to transfusion practice, the need to blood transfusion isincreased in current cardiac operations in our center, due to association ofmore co-morbidity.

Increased Demand for Blood Transfusion in Cardiac Surgery, Simple but Unsolved Common Problem Keywords:

Blood conservation , Coronary artery bypass grafting , CPB