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The Annals of Thoracic Surgery, Vol 40, 380-384, Copyright © 1985 by The Society of Thoracic Surgeons
DM Cosgrove, FD Loop, BW Lytle, CC Gill, LR Golding, PC Taylor and SB Forsythe
Blood transfusion during cardiac surgical procedures has steadily
decreased, but little information is available regarding the factors that
determine its necessity or amount. To determine the predictors of blood
utilization during myocardial revascularization, 441 consecutive patients
undergoing primary myocardial revascularization were studied. Forty-four
patients (10%) received blood during hospitalization with a mean
transfusion of 0.3 +/- 1.4 units per patient. Age, sex, weight, body
surface area, preoperative hematocrit, blood volume, and red blood cell
volume were examined univariately for trends. All demonstrated a
statistically significant trend for both need and amount of transfusion (p
less than 0.001). Neither number of grafts nor duration of cardiopulmonary
bypass demonstrated statistically significant trends. All univariately
significant factors were evaluated by multivariate logistic regression
analysis. Red cell volume was the best predictor of the need for
transfusion (p less than 0.001), followed by age. No other factors improved
predictive capabilities. We conclude that preoperative red cell mass and
age are the principal determinants of the need for and quantity of blood
transfused during myocardial revascularization. Use of this information may
greatly improve the efficiency of ordering blood before operation.
ARTICLES
Determinants of blood utilization during myocardial revascularization
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B. P Bidstrup Review article : Blood conservation in cardiac surgery: can drugs help? Perfusion, July 1, 1988; 3(3): 171 - 177. [PDF]
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