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Background: The objective of this study was to compare liberal and prophylactic transfusion, acute normovolemic hemodilution plus a restrictive on-demand regimen and ROTEM®-guided transfusion protocols to optimize use of blood products and in-hospital outcomes in adult cardiac surgery. Methods: Three cohorts of patients were retrospectively analyzed: 131 patients undergoing all types of cardiac surgery were assigned to liberal transfusion, 117 to normovolemic hemodilution, and 100 to ROTEM-guided transfusion. Eligibility for one or the other protocol was based on the anesthesiologists’ preferences. Results: Utilization of total packed red blood cells was significantly higher in the liberal transfusion protocol (2 units IQR 1-3), with respect to hemodilution and ROTEM® protocols (1 unit, IQR 0-3 and 1 unit, IQR 0-2, respectively) (p |
