Risk Factors Related to Transfusion Requirements in Patients Undergoing Implantation of Ventricular Assist Devices
| Autor: | Francis D. Pagani, Sean Neill, Theresa A. Shields, Milo Engoren, Elizabeth S. Jewell, Yasser Kouatli |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Adrenergic beta-Antagonists Blood Loss Surgical Single Center Prosthesis Implantation Risk Factors Blood product medicine Coagulopathy Humans Blood Transfusion Platelet Myocardial infarction Cardiac Surgical Procedures Retrospective Studies business.industry Cardiogenic shock Middle Aged medicine.disease Surgery Anesthesiology and Pain Medicine Platelet transfusion Ventricular assist device Anesthesia Female Heart-Assist Devices Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia. 29:297-302 |
| ISSN: | 1053-0770 |
| DOI: | 10.1053/j.jvca.2014.07.002 |
| Popis: | Objective The identification of transfusion risk factors in patients receiving left ventricular assist devices to allow for targeted use of blood conservation strategies and improved blood utilization. Design This is a retrospective analysis of prospectively collected data between April 2009 and June 2012. Linear regression was used to determine factors associated with increased transfusion. Logistic regression was used to determine factors that were associated with more than the median number of units transfused. Setting Single center, university hospital. Participants Patients (n = 144) who underwent left ventricular assist device implantation. Intervention Transfused blood product data for the day of surgery and for 3 days after were obtained from the blood bank. Measurements and Main Results Beta-blockers were associated with 1.7±0.65 fewer red blood cell (RBC) units and 2.2±0.7 fewer fresh frozen plasma units transfused. Each year of older age was associated with 0.113±0.023 units of RBC, 0.543±0.101 platelet, and 0.098±0.017 plasma units transfused. International normalized ratio was associated with more platelet transfusion (20.813±5.757 units per 1.0 increase), but not with plasma or RBC transfusion. Lower platelet counts were associated with both platelet (-0.045±0.019 units per 10,000 μL -1 ) and plasma transfusions (-0.011±0.004). Myocardial infarction was associated with increased RBC and plasma transfusion, and cardiogenic shock was associated with increased platelet transfusions, but nitrate use was associated with reduced platelet transfusion. Conclusion Beta-blockers may be a modifiable factor to decrease transfusions. The association between international normalized ratio and platelet transfusions suggests that better determination of the type of coagulopathy may promote more appropriate transfusions. |
| Databáze: | OpenAIRE |
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