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  • A restrictive perioperative transfusion strategy does not increase all-cause mortality (30 days) or morbidity compared with a liberal approach in patients undergoing cardiac surgery

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Therapeutics
Randomised controlled trial
A restrictive perioperative transfusion strategy does not increase all-cause mortality (30 days) or morbidity compared with a liberal approach in patients undergoing cardiac surgery
  1. Dimitrios Mikroulis1,
  2. Nikolaos Papanas1,
  3. Georgios Vretzakis2,3
  1. 1Cardiothoracic Surgery Department, Democritus University Thrace, University Hospitalof Alexandroupolis, Greece
  2. 2Internal Medicine Department,Democritus University Thrace,University Hospitalof Alexandroupolis, Greece
  3. 3Department of Anesthesiology, University Hospital of Larissa, Larissa, Greece
  1. Correspondence to Dimitrios Mikroulis
    Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis PC 68100, Greece; dmikrou{at}med.duth.gr

https://doi.org/10.1136/ebm1186

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    Commentary on: Hajjar LA, Vincent JL, Galas FR, et al. Transfusion requirements after cardiac surgery: the TRACS randomized controlled trial. JAMA 2010;304:1559–67.OpenUrlCrossRefPubMedWeb of Science

    Context

    Cardiac surgery is associated with a high rate of allogeneic blood transfusion (BT), varying from 40% to 90% in most centres. However, BT may be both beneficial and harmful. Severe anaemia is an independent risk factor for cardiac surgery morbidity and mortality, but BT substantially increases costs and is associated with adverse outcomes, including increased rates of infections, neurologic complications, renal failure and decreased in-hospital and long-term survival after cardiac operations. The decision for transfusion is often based on haemoglobin or haematocrit levels, but there are no evidence-based guidelines on transfusion triggers after cardiac surgery.1

    Methods

    A prospective, randomised, non-inferiority controlled trial was conducted at the Heart Institute of the University of Sao Paulo, Sao Paulo, Brazil, between February …

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    Footnotes

    • Competing interests None.