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THURSDAY, June 20, 2019 (HealthDay News) — For high-risk patients undergoing cardiac surgery with cardiopulmonary bypass, a restrictive approach to red blood cell transfusions leads to fewer transfusions than a liberal approach, with no increase in the risk for acute kidney injury (AKI), according to a study published online June 20 in the Journal of the American Society of Nephrology<\/i>.<\/p>\n
Amit X. Garg, M.D., Ph.D., from the London Health Sciences Centre and Western University in Canada, and colleagues compared a restrictive versus liberal threshold for red blood cell transfusion among 4,531 patients undergoing cardiac surgery with cardiopulmonary bypass with moderate-to-high risk of perioperative death.<\/p>\n
The researchers found that compared with the liberal-threshold group, patients in the restrictive-threshold group received significantly fewer transfusions (1.8 versus 2.9 on average, or 38 percent fewer). AKI occurred in 27.7 and 27.9 percent of patients in the restrictive-threshold and liberal-threshold groups, respectively. Among patients with preoperative chronic kidney disease, AKI occurred in 33.6 and 32.5 percent of patients in the restrictive-threshold and liberal-threshold groups, respectively.<\/p>\n
“With over 20 million cardiac surgeries performed worldwide each year — with it being one of the more common reasons for using blood in the hospital and an average of about three units of red blood cells used per patient — this suggests that approximately 20 million units of blood transfusions could be avoided each year without influencing the chance that a patient will develop postoperative kidney injury,” Garg said in a statement.<\/p>\n
Several authors disclosed financial ties to the pharmaceutical industry.<\/p>\n
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