Bleeding in Cardiac Surgery: Should Massive Transfusion Be in a 1:1:1 Ratio?
Nearly 10% of postoperative cardiothoracic surgery patients will require transfusion of at least five units of packed red blood cells. This transfusion requirement is multifactorial, however cardiothoracic patients should be considered higher risk for hemorrhage. The optimal transfusion ratio for post cardiac surgery hemorrhage is unclear. Conversely, for trauma patients, the effect of transfusion ratios on outcomes has been studied extensively. For these patients, a balanced transfusion ratio of 1:1:1 (plasma, platelets, red blood cells) results in a decrease in bleeding specific mortality.
KeywordsMassive transfusion Cardiothoracic surgery Postoperative complication Postoperative hemorrhage Transfusion ratios
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