Restrictive Transfusion Strategy after Cardiac Surgery

Background Recent guidelines on transfusion in cardiac surgery suggest that hemoglobin might not be the only criterion to trigger transfusion. Central venous oxygen saturation (Svo2), which is related balance between tissue delivery and consumption, may help decision process of We designed a randomized study test whether central Svo2–guided could reduce incidence after surgery. Methods This single center, single-blinded, controlled trial was conducted adult patients intensive care unit (ICU) tertiary university hospital. Patients were screened preoperatively assigned randomly two groups (control or Svo2) if they developed anemia (hemoglobin less than 9 g/dl), without active bleeding, during their ICU stay. transfused at each episode stay except Svo2 who pretransfusion equal 65%. The primary outcome proportion ICU. main secondary endpoints (1) number erythrocyte units discharge, (2) discharge. Results Among 484 patients, 100 randomized, with 50 group. All control total 94 units. In group, 34 (68%) (odds ratio, 0.031 [95% CI, 0 0.153]; P < 0.001 vs. controls), 65 At eight group remained nontransfused cumulative count 96 126 Conclusions A restrictive strategy adjusted allow significant reduction Editor’s Perspective What Already Know about Topic Article Tells Us That Is New