Strategy of transfusion in cardiac surgery: limits of hematocrit and how much is too low?

Author: Jakobsen, Carl-Johan

Source: Future Cardiology, Volume 3, Number 2, March 2007 , pp. 141-151(11)

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Future Cardiology reflects the new era of cardiology and highlights new molecular approaches in advancing cardiovascular therapy. The journal publishes clinical research, commentary and therapeutic overviews highlighting optimal therapy and future options and strategies.
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Abstract:

The use of blood and blood products in cardiac surgery is higher than necessary and a reduction is imperative due to complications and costs. Hemodilution is unavoidable in cardiopulmonary bypass and is the most likely pitfall when evaluating transfusion needs. Even patients with coexisting cardiovascular diseases tolerate perioperative hemodilution better than most anticipate. Hemodynamic monitoring is important to evaluate the association between hemoglobin level and organ function. Use of both mechanical and medical blood conservation strategies is required to reduce blood transfusion, and most of the methods have a positive cost-effectiveness and cost-benefit. By using the right strategy and policy, transfusion of blood and blood products can be reduced to less than 5% of cardiac patients.

Keywords: aprotinin; autolog transfusion; cardiac surgery; erythropoietin; hematocrit; hemodilution; hemodynamics; transfusion

Document Type: Research article

DOI: 10.2217/14796678.3.2.141