Year : 2008  |  Volume : 11  |  Issue : 2  |  Page : 134--135

Blood transfusion in cardiac surgery


Ramachandran Gopinath 
 Department of Anaesthesiology and Intensive Care, Nizam's Institute of Medical Sciences, Hyderabad, India

Correspondence Address:
Ramachandran Gopinath
Department of Anaesthesiology and Intensive Care, Nizam«SQ»s Institute of Medical Sciences, Punjagutta, Hyderabad. 500082
India




How to cite this article:
Gopinath R. Blood transfusion in cardiac surgery.Ann Card Anaesth 2008;11:134-135


How to cite this URL:
Gopinath R. Blood transfusion in cardiac surgery. Ann Card Anaesth [serial online] 2008 [cited 2021 Jan 19 ];11:134-135
Available from: https://www.annals.in/text.asp?2008/11/2/134/41587


Full Text

The Editor,

I read with interest the article by Dr. Scott et al , on "Blood transfusion is associated with increased resource utilisation, morbidity and mortality in cardiac surgery." Although the Society of Thoracic Surgeons has laid down guidelines for transfusion of blood and products, individual and institutional practices vary. An editorial by Adamson JW [1] and an interesting article by Koch et al. [2] from Cleveland Clinic were published in the New England Journal of Medicine (NEJM). This article examined the duration of storage of transfused blood and the complications following cardiac surgery and showed that more than two weeks of storage increases the complication rate. This finding raises questions as to whether blood should be stored for more than two weeks at all and if this applies to all patients who receive transfusions, regardless of the indication. This latter question arises because we assume that only patients who are sick receive transfusions in the perioperative period. When and for how long can blood reasonably be assumed to be "Safe"? Longer durations (arbitrarily >14 days) of storage seem to result in structural and biochemical changes that influence the complication rate especially in vulnerable patients with co-morbidities. Our practice has been to transfuse at an Haemoglobin (Hb) trigger of 8 g/dL. Could we have been causing higher mortality by doing so? In this regard, the practice of using recently donated blood (read "fresh"!!) in the Indian context seems to be a healthy one!!!

References

1An editorial by Adamson JW and an interesting article by Koch et al . from Cleveland Clinic were published in the New England Journal of Medicine (NEJM).
2Koch CG, Li L, Sessler DI, Figueroa P, Hoeltge GA, Mihaljevic T, et al. Duration of red-cell storage and complications after cardiac surgery. N Engl J Med 2008;358:1229-39.