A liberal strategy of red blood cell transfusion reduces cardiogenic shock in elderly patients undergoing cardiac surgery Rosana Ely Nakamura, MD, Jean-Louis.

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Presentation transcript:

A liberal strategy of red blood cell transfusion reduces cardiogenic shock in elderly patients undergoing cardiac surgery Rosana Ely Nakamura, MD, Jean-Louis Vincent, PhD, Julia Tizue Fukushima, MSc, Juliano Pinheiro de Almeida, MD, PhD, Rafael Alves Franco, MD, Clarice Lee Park, MD, Eduardo Atsushi Osawa, MD, Carolina Maria Pinto Silva, MD, Jose Otavio Costa Auler, PhD, Giovanni Landoni, PhD, Filomena Regina Barbosa Gomes Galas, PhD, Roberto Kalil Filho, PhD, Ludhmila Abrahao Hajjar, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 150, Issue 5, Pages 1314-1320 (November 2015) DOI: 10.1016/j.jtcvs.2015.07.051 Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Flowchart of the study. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 1314-1320DOI: (10.1016/j.jtcvs.2015.07.051) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Mean hemoglobin levels during the study in patients aged less than 60 years (top) and patients aged 60 years or more (bottom) according to transfusion strategy. IO, Intraoperative period; IPO, immediate postoperative period. D1-D7 indicate postoperative days. P < .05. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 1314-1320DOI: (10.1016/j.jtcvs.2015.07.051) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Percentage of patients aged less than 60 years (top) and patients aged 60 years or more (bottom) who received an RBC transfusion in the liberal and restrictive strategy groups. IO, Intraoperative period; IPO, immediate postoperative period. D1-D7 indicate days after ICU admission. *P < .05 (comparison between groups – logistic regression for repeated measures). The Journal of Thoracic and Cardiovascular Surgery 2015 150, 1314-1320DOI: (10.1016/j.jtcvs.2015.07.051) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Cardiogenic shock occurs in elderly persons after cardiac surgery when exposed to RBC transfusion. This study illustrates that elderly patients undergoing cardiac surgery, in contrast to younger patients, have a greater risk of cardiogenic shock when exposed to a restrictive strategy of RBC transfusion. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 1314-1320DOI: (10.1016/j.jtcvs.2015.07.051) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions