Cardiopulmonary bypass management and acute kidney injury in 118 Jehovah's Witness patients: a retrospective propensity-matched multicentre cohort from 30,942 patients
| Autor: | Timothy W Willcox, Richard F. Newland, Robert A. Baker |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Jehovah s witness 030204 cardiovascular system & hematology law.invention Cohort Studies 03 medical and health sciences 0302 clinical medicine law Cardiopulmonary bypass medicine Humans Radiology Nuclear Medicine and imaging Propensity Score Jehovah's Witnesses Retrospective Studies Advanced and Specialized Nursing Cardiopulmonary Bypass business.industry Acute kidney injury General Medicine Acute Kidney Injury medicine.disease Cardiac surgery 030228 respiratory system Cohort Emergency medicine Female Cardiology and Cardiovascular Medicine business Safety Research |
| Zdroj: | Perfusion. 35(8) |
| ISSN: | 1477-111X |
| Popis: | Introduction: Patients refusing blood products in cardiac surgery present challenges for cardiopulmonary bypass. Accurate detail of the modifiable factors of cardiopulmonary bypass relating to acute kidney injury is previously unreported in this patient population. Methods: A total of 118 adult Jehovah’s Witness patients refusing transfusion were propensity matched to 118 adult patients accepting transfusion from the 30,942 patients in the Australian and New Zealand Collaborative Perfusion Registry. The primary endpoint was acute kidney injury. Intraoperative and bypass management characteristics were also compared between early (2007-2012) and late (2013-2018) cohorts along with the acceptance or refusal of transfusion. Results: In patients accepting transfusion, 49% received a blood product. In patients refusing transfusion, acute kidney injury was lower (8% vs. 22%; p = 0.003) cell salvage use was higher (70% vs. 22%; p 2i), retrograde autologous prime, circuit prime volume) between the two groups; however, prime volume decreased and DO2i increased over time for both. Patients refusing transfusion had lower postoperative blood loss (p = 0.02) and shorter postoperative length of stay (p Conclusion: Refusal of transfusion in patients undergoing cardiopulmonary bypass was associated with reduced acute kidney injury, hospital stay and postoperative blood loss, while not impacting mortality. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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