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Bleeding in Cardiac Surgery: Should Massive Transfusion Be in a 1:1:1 Ratio?

  • James M. Bardes
  • Kenji InabaEmail author
Chapter
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)

Abstract

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.

Keywords

Massive transfusion Cardiothoracic surgery Postoperative complication Postoperative hemorrhage Transfusion ratios 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Trauma and Acute Care SurgeryLos Angeles County and University of Southern California Medical CenterLos AngelesUSA

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