Cardiothoracic & vascular anesthesia
The Adherence to an Intraoperative Blood Product Transfusion Algorithm Is Associated With Reduced Blood Product Transfusions in Cardiac Surgical Patients Undergoing Coronary Artery Bypass Grafts and Aortic and/or Valve Replacement Surgery: A Single-Center, Observational Study
Authors' conclusion
After the implementation of a viscoelastic-based algorithm, patients received fewer packed RBC, FFP, platelets, cryoprecipitate, and cell saver.
Study context
- Population
- Adult cardiac surgical patients (CABG and aortic and/or valve replacement), quaternary academic teaching hospital
- Participants
- 236 vs 184
- Exposure
- Historic controls vs Algorithm
- Historic controlsn = 236reference
- Algorithmn = 184
- Outcome
- Intraoperative blood product transfusion rates
Methodological detailssingle-centre, historic controls
- Single-centre
- Historic controls
Main finding
As reported in the abstract
- Fresh frozen plasma (FFP) units: Historic controls 0.84 ± 1.4 vs Algorithm 0.64 ± 1.38; reduction 23.8%, p = ns
- Platelet units: 0.90 ± 1.39 vs 0.60 ± 131; reduction 33.4%, p = ns
- Cryoprecipitate units: 0.19 ± 0.54 vs 0.16 ± 0.50; reduction 15.8%, p = ns
- Red blood cell (RBC) units: 1.98 ± 2.24 vs 0.55 ± 1.36; reduction 43.9%, p = 0.008
- Group order of values as printed (controls first not stated explicitly)
Observational data: associations, not effects.
Further findings
Time to extubation, ICU LOS, hospital LOS
- Time to extubation: 8.0 hours (4.0-21.0) v 8.0 (4.0-22.3); no statistically significant difference
- ICU LOS: 51.0 hours [28.0-100.5] v 53.5 [33.3-99.0]; no statistically significant difference
- Hospital LOS: 9.0 days [6.0-15.0] v 10.0 [7.0-17.0]; no statistically significant difference
Algorithm adherence
- Deviation from algorithm adherence
- 32.7% (48/147)
- Packed RBC, FFP, platelets, cryoprecipitate and cell saver significantly reduced in Algorithm Compliant Cohort vs historic controls; extubation time, ICU LOS and hospital LOS not significant
Safety
Reoperation for bleeding
- 15 [12.3%] v 10 [10.6%]; no statistically significant difference
Original publication
The Adherence to an Intraoperative Blood Product Transfusion Algorithm Is Associated With Reduced Blood Product Transfusions in Cardiac Surgical Patients Undergoing Coronary Artery Bypass Grafts and Aortic and/or Valve Replacement Surgery: A Single-Center, Observational Study. J Cardiothorac Vasc Anesth. Published 1 February 2024. doi:10.
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