Blood transfusion in cardiac surgeries - Toward a personalized protocol
[...]leveraging the empirical results of these randomized trials, modern surgical and anesthesia task force recommendations have focused on static, one-size-fits-all transfusion triggers,4 including the 2021 STS/SCA/AmSECT/SABM updated patient blood management guidelines.5 However, transfusion polic...
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Published in | The American journal of surgery Vol. 227; pp. 237 - 238 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Elsevier Limited
01.01.2024
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Subjects | |
Online Access | Get full text |
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Summary: | [...]leveraging the empirical results of these randomized trials, modern surgical and anesthesia task force recommendations have focused on static, one-size-fits-all transfusion triggers,4 including the 2021 STS/SCA/AmSECT/SABM updated patient blood management guidelines.5 However, transfusion policies utilizing a static, one-size-fits-all threshold may overlook individual characteristics that correlate with patients’ HGB level and result in unnecessary transfusions for patients. [...]a recent retrospective study showed females undergoing surgical procedures are at an increased blood transfusion risk despite adjusting for height and weight.6 However, truly personalized transfusion protocols (e.g., accounting for a patient's HGB baseline and tolerance to blood loss) have not been investigated in any randomized clinical trials. [...]current guidelines are built on studies that only consider one-size-fits all approaches. Male HGB on average is 1.65 g/dL (Confidence Interval: 1.62–1.69) higher than that of female's, a difference equivalent to at least 1.5 units of packed RBC transfusion, assuming a standard 1 g/dL increase in HGB per unit in a 70kg patient. |
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Bibliography: | SourceType-Other Sources-1 content type line 63 ObjectType-Editorial-2 ObjectType-Commentary-1 |
ISSN: | 0002-9610 1879-1883 |
DOI: | 10.1016/j.amjsurg.2023.07.035 |