Intensive Care Medicine

, Volume 35, Issue 9, pp 1548–1555

Relationships among haemoglobin level, packed red cell transfusion and clinical outcomes in patients after cardiac surgery

  • Eva Oliver
  • Maria L. Carrio
  • David Rodríguez-Castro
  • Casimiro Javierre
  • Elisabet Farrero
  • Herminia Torrado
  • Eduard Castells
  • Josep L. Ventura
Original

DOI: 10.1007/s00134-009-1526-0

Cite this article as:
Oliver, E., Carrio, M.L., Rodríguez-Castro, D. et al. Intensive Care Med (2009) 35: 1548. doi:10.1007/s00134-009-1526-0

Abstract

Objective

To identify associations among haemoglobin (Hb) concentrations, blood transfusions, and clinical outcomes in patients after cardiac surgery, especially in those who undergo valve replacement or bypass surgery.

Design

Prospective observational trial.

Setting

Surgical intensive care unit in a tertiary-level university hospital.

Patients

1216 Consecutive patients.

Measurements

Haemoglobin at admission and 6, 12, 24, and 48 h later, and then, every 24 h while patients remained in the intensive care unit (ICU); number of transfusions and clinical events.

Results

Patients were divided into quartiles according to minimal haemoglobin, the first and second of which (Hb <8.10 and <8.91 g/dL, respectively) differed significantly (P < 0.001) from the other two quartiles in terms of more organ failure, longer ICU stay, and higher mortality. We found associations between being transfused ≥4 packed red cells (PRCs) and a worse clinical outcome and higher mortality. The associated mortality rate was higher for patients who underwent bypass surgery when they had Hb ≤8.9 g/dL and for those who underwent valve replacement when they had Hb >8.9 g/dL and were transfused ≥4 PRCs.

Conclusions

Low haemoglobin concentrations and transfusions in patients undergoing cardiac surgery are associated with increased morbidity and mortality. Also, anemia and transfusions are associated with poor outcome. Therefore, intra- and postoperative bleeding seem to be a risk factor in patients undergoing cardiac surgery.

Keywords

Cardiac surgery Haemoglobin Transfusions Outcome Mortality 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Eva Oliver
    • 1
  • Maria L. Carrio
    • 1
  • David Rodríguez-Castro
    • 1
  • Casimiro Javierre
    • 2
  • Elisabet Farrero
    • 1
  • Herminia Torrado
    • 1
  • Eduard Castells
    • 3
  • Josep L. Ventura
    • 1
  1. 1.Department of Intensive CareHospital Universitari de Bellvitge, Feixa Llarga s/nBarcelonaSpain
  2. 2.Faculty of MedicineHospital Universitari de Bellvitge, Feixa Llarga s/nBarcelonaSpain
  3. 3.Department of Cardiac SurgeryHospital Universitari de Bellvitge, Feixa Llarga s/nBarcelonaSpain

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