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LETTER TO EDITOR Table of Contents   
Year : 2008  |  Volume : 11  |  Issue : 2  |  Page : 136-137
Blood transfusion is associated with increased resource utilisation, morbidity, and mortality in cardiac surgery


Anaesthesia and Critical Care, Indraprastha Apollo Hospital, New Delhi, India

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How to cite this article:
Juneja R, Mehta Y. Blood transfusion is associated with increased resource utilisation, morbidity, and mortality in cardiac surgery. Ann Card Anaesth 2008;11:136-7

How to cite this URL:
Juneja R, Mehta Y. Blood transfusion is associated with increased resource utilisation, morbidity, and mortality in cardiac surgery. Ann Card Anaesth [serial online] 2008 [cited 2014 Jul 31];11:136-7. Available from: http://www.annals.in/text.asp?2008/11/2/136/41591


The Editor,

We read with interest the article on blood transfusion by Scott et al. [1] Low haematocrit on cardio pulmonary bypass (CPB) (<22%), which is independently associated with stroke, myocardial infarction (MI), renal failure, prolonged ventilation, sepsis, reoperation due to bleeding, [2],[3] has not been taken into consideration. The discussion could have been more detailed, such as attempting to explain why patients with cerebro vacular accident (CVA) and chronic obstructive pulmonary disease (COPD) had higher transfusion rates.

Linear regression showed increased resource utilisation in all transfused patients and in 263 patients with "no preoperative morbidity", which led to the conclusion that transfusion is an independent predictor of resource utilisation.

The authors included only MI, diabetes mellitus, hypertension, congestive heart failure, and renal failure in "no preoperative morbidity" patients and not female sex, preoperative haematocrit, COPD, CVA, and peripheral vascular disease, which significantly affect resource utilisation. [2] Surgical data such as longer CPB time, increased intra artic baloon pump use, bleeding requiring reoperation, postoperative renal failure, postoperative CVA are independently associated with higher resource utilisation, [2] and Table 1 and Table 2 show a significant difference between the transfused and non-transfused patients. We are of the opinion that it would be incorrect to arrive at the derived conclusion without reference to these variables.

 
   References Top

1.Scott BH, Seifert FC, Grimson R. Blood transfusion is associated with increased resource utilization, morbidity and mortality in cardiac surgery. Ann Cardiac Anaesth 2008;11:15-9.  Back to cited text no. 1    
2.Society of Thoracic Surgeons Blood Conservation Guideline Task Force, Ferraris VA, Ferraris SP, Saha SP, Hessel EA 2nd, Haan CK, et al. Perioperative blood transfusion and blood conservation in cardiac surgery: The society of thoracic surgeons and the society of cardiovascular anesthesiologists clinical practice guideline. Ann Thorac Surg 2007;83:S27-86.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Habib RH, Zacharias A, Schwan TA, Riordan CJ, Durham SJ, Shah A. Adverse effects of low hematocrit during cardiopulmomonary bypass in the adult: Should the current practice be changed? J Thorac Cardiovasc Surg 2003;125:1438-50.  Back to cited text no. 3    

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Correspondence Address:
Rajiv Juneja
B3/63, Safdarjung Enclave, New Delhi
India
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DOI: 10.4103/0971-9784.41591

PMID: 18603761

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