Original articleAdult cardiacThe Impact of Blood Conservation on Outcomes in Cardiac Surgery: Is It Safe and Effective?
Section snippets
Material and Methods
Since its inception in 2000 the cardiac surgery program at Englewood Hospital and Medical Center has a well-established blood conservation protocol. The program was started as part of the “Blood Conservation Demonstration Project” under the auspices of the New Jersey State Department of Health and Senior Services (NJDHSS) certificate of need (NJAC 8:33-3.11). The goal of the project was to implement blood conservation in cardiac surgery and report on its safety and efficacy. The techniques and
Results
The total study population consisted of 32,449 patients who underwent isolated CABG surgery from June 2000 until December 2004 with complete data from 17 institutions. There were 31,863 patients from the OH and 586 were from EH. From the pool of patients in the OH group, a match was selected for each OH patient on the basis of the closest propensity score. Five hundred eighty-six matched patients were selected to form the OH-M cohort (Table 2). Patient demographics and risk factors for the EH
Comment
There is large variability in transfusion rates among cardiac surgery centers. On average 50% to 60% of patients undergoing cardiac surgery receive blood transfusions and about 20% of the nation's blood supply is used in cardiac surgery [33]. Guidelines for blood transfusions in patients without known risk factors suggest a transfusion trigger in the range of 6 to 10 g/dL [17]. Cardiac surgical patients represent a particularly vulnerable population that may be adversely affected by anemia
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