Cardiothoracic & vascular anesthesia
Less Is More for Bleeding Management Algorithms in Cardiac Surgery: A Network Meta-Analysis and Meta-Regression of Randomized Studies
Pooled result · RBC units transfusedResult — go to the resultMean difference −0.43 units 95% CI −0.80 to −0.07Authors' conclusion
Overall, viscoelastic test-based BMAs are superior to conventional strategies in limiting RBC transfusions in the presence of major bleeding; however, a restrictive strategy of procoagulant administration is superior to a liberal strategy in terms of RBC transfusion containment.
Study context
- Population
- Cardiac surgery patients with major bleeding managed with a bleeding management algorithms (BMA)
- Comparison
- Restrictive BMAs vs Liberal BMAs
- Outcome
- RBC transfusions (rate and units)
Methodological details2 network meta-analyses
- 2 network meta-analyses
Pooled result
RBC units transfused
Mean difference
−0.43 units
95% CI −0.80 to −0.07
P = 0.020
Restrictive BMAs vs Liberal BMAs
mean difference −0.43 units (95% CI −0.80 to −0.07); P = 0.020
As reported in the abstract
Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| RBC transfusion rate (meta-regression, corrected for complexity of surgery and hematocrit trigger)Restrictive BMAs vs Liberal BMAs | 0.728 (0.569–0.932) | P = 0.012 | |
| 0.512Odds ratio (log scale) |
| Outcome | P value |
|---|---|
| Use of any procoagulantRestrictive BMAs vs Liberal BMAs · significantly lower with restrictive BMAs | P = 0.001 |
Original publication
Less Is More for Bleeding Management Algorithms in Cardiac Surgery: A Network Meta-Analysis and Meta-Regression of Randomized Studies. Anesth Analg. Published 17 September 2025. doi:10.
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