Transfusion after coronary artery bypass surgery: the impact of heparin-bonded circuits
| Autor: | Chris Brown Mahoney, Gerald M. Lemole |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.drug_class law.invention Coronary artery bypass surgery Coated Materials Biocompatible Randomized controlled trial Risk Factors law Catheterization procedure Odds Ratio Cardiopulmonary bypass Humans Medicine Prospective Studies Derivation Coronary Artery Bypass Postoperative Care Body surface area Cardiopulmonary Bypass Heparin business.industry Anticoagulant Anticoagulants General Medicine Length of Stay Middle Aged Surgery Treatment Outcome Anesthesia Female Erythrocyte Transfusion Cardiology and Cardiovascular Medicine Packed red blood cells business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 16:206-210 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/s1010-7940(99)00157-8 |
| Popis: | Objective: To identify the impact of heparin bonded (Carmedaw) circuits on the need for transfusion of packed red blood cells (PRBC) after CABG independent of the influence of patient, procedural, and surgical experience variables. Methods: A prospective, randomized trial examined the impact of heparin-bonded circuits in 210 patients undergoing coronary artery bypass surgery at Medical Center of Delaware (Christiana Care Health Services). Patients were randomized to either non-bonded circuits or heparin-bonded (Carmedaw) circuits. There were no significant differences in patient characteristics between the treatment and control group. A multivariate analysis was performed to identify the independent predictors of both the need for transfusion (logistic) and number of units of PRBC transfused (OLS). Results: The only significant (P , 0:05) independent predictors of need for transfusion were gender (odds ratioOORUa0:35 for males), use of anticoagulants prior to surgery (ORa 2:09), cross-clamp time (ORa 1:03 for each extra minute), and use of heparin-bonded circuits (ORa 0:50 for patients in the heparin-bonded; Carmedaw, circuit group). The only significant independent predictors of number of PRBCs were anticoagulants prior to surgery, cross-clamp time, catheterization procedure on the same day, body surface area, and use of heparin-bonded circuits. Other patient demographic variables, comorbidities, and surgical variables were not significant independent predictors of the need for transfusion or the number of units transfused. Conclusions: Several factors influence the probability of transfusion that patients face following coronary artery bypass surgery. The probability of transfusion is 50% less and the number of PRBCs transfused are 1.42 units less when heparin-bonded (Carmedaw) circuits are used, adjusted for patient demographics, comorbidities, or surgical variables. q 1999 Elsevier Science B.V. All rights reserved. |
| Databáze: | OpenAIRE |
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