Transfusion Increases the Risk for Vasoplegia After Cardiac Operations

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Presentation transcript:

Transfusion Increases the Risk for Vasoplegia After Cardiac Operations Andrej Alfirevic, MD, Meng Xu, MS, Douglas Johnston, MD, Priscilla Figueroa, MD, Colleen G. Koch, MD The Annals of Thoracic Surgery Volume 92, Issue 3, Pages 812-819 (September 2011) DOI: 10.1016/j.athoracsur.2011.04.020 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Variables significantly related to odds for developing mild vasoplegia. (ACE = angiotensin-converting enzyme; Afib = atrial fibrillation; CI = confidence interval; CPB = cardiopulmonary bypass; FFP = fresh-frozen plasma; HCT = hematocrit (%); LVF* = left ventricular function—normal-mild vs moderate-severe; OR = odds ratio). The Annals of Thoracic Surgery 2011 92, 812-819DOI: (10.1016/j.athoracsur.2011.04.020) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Probability in unadjusted odds ratios (OR) of developing mild vasoplegia by number of red blood cells (RBC) transfused. (B) Risk-adjusted probability in odds ratios (OR) of developing mild vasoplegia by number of red blood cell (RBC) units transfused in an intermediate risk patient as calculated for a 70-year-old man with diabetes, history of atrial fibrillation and myocardial infarction, no hypertension, no endocarditis, moderate-severe left ventricular function on preoperative angiotensin-converting enzyme inhibitors, no calcium channel blockers, creatinine (1.4 mg/dL), cardiopulmonary bypass duration of 90 minutes, hematocrit of 30, who receives a transfusion of fresh frozen plasma and platelets. The Annals of Thoracic Surgery 2011 92, 812-819DOI: (10.1016/j.athoracsur.2011.04.020) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Perioperative variables significantly related to the odds of developing profound vasoplegia. (Afib = atrial fibrillation; CI = confidence interval; CPB = cardiopulmonary bypass; FFP = fresh frozen plasma; HCT = hematocrit (%); LVF* = left ventricular function—normal-mild vs moderate-severe; OR = odds ratio; RBC = red blood cells.) The Annals of Thoracic Surgery 2011 92, 812-819DOI: (10.1016/j.athoracsur.2011.04.020) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) Probability in unadjusted odds ratios (OR) of developing profound vasoplegia by number of red blood cell (RBC) units transfused. (B) Risk-adjusted probability in odds ratios (OR) of developing profound vasoplegia by number of red blood cell (RBC) units transfused in an intermediate risk patient. The Annals of Thoracic Surgery 2011 92, 812-819DOI: (10.1016/j.athoracsur.2011.04.020) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions