Benjamin C. Sun, MD, Timothy A. Dickinson, CCP, Eric A

Slides:

Advertisements

Similar presentations

The association of lowest hematocrit during cardiopulmonary bypass with acute renal injury after coronary artery bypass surgery Madhav Swaminathan, MD,

Advertisements

Persistent Effect of Red Cell Transfusion on Health-Related Quality of Life After Cardiac Surgery Colleen Gorman Koch, MD, MS, Farah Khandwala, MS, Liang.

Major Bleeding, Transfusions, and Anemia: The Deadly Triad of Cardiac Surgery Marco Ranucci, MD, FESC, Ekaterina Baryshnikova, BD, Serenella Castelvecchio,

What Predicts Long-Term Survival After Heart Transplantation

Cumulative Corticosteroid Exposure and Infection Risk After Complex Pediatric Cardiac Surgery Christopher W. Mastropietro, MD, Renee Barrett, MD, Maria.

Coronary Artery Bypass for Heart Failure in Ischemic Cardiomyopathy: 17-Year Follow- Up Marco Pocar, MD, PhD, Andrea Moneta, MD, Adalberto Grossi, MD,

Contemporary Bloodletting in Cardiac Surgical Care

Amit Iyengar, Christopher N. Scipione, MD, Parth Sheth, Richard G

Robert Brewer, MD, MHSA, Patricia F. Theurer, BSN, Chad M

Constantin Stefanidis, MD, Albert M

The Myocardial Protective Effects of a Moderate-Potassium Blood Cardioplegia in Pediatric Cardiac Surgery: A Randomized Controlled Trial Yang Liu, MD,

Gaetano Paone, MD, MHSA, Robert Brewer, MD, MHSA, Donald S

Variation in Red Blood Cell Transfusion Practices During Cardiac Operations Among Centers in Maryland: Results From a State Quality-Improvement Collaborative

Theron A. Paugh, CCP, Timothy A. Dickinson, MS, James R

Autologous Platelet-Rich Plasma Reduces Transfusions During Ascending Aortic Arch Repair: A Prospective, Randomized, Controlled Trial Shao Feng Zhou,

Long-Term Consequences of Postoperative Heart Failure After Surgery for Aortic Stenosis Compared With Coronary Surgery Farkas B. Vánky, MD, PhD, Erik.

Impact of Medicaid Expansion on Cardiac Surgery Volume and Outcomes

Platelet Transfusion in Cardiac Surgery Does Not Confer Increased Risk for Adverse Morbid Outcomes Tory McGrath, MD, Colleen Gorman Koch, MD, MS, Meng.

Age of Transfused Red Cells and Early Outcomes After Cardiac Surgery

Comparing Long-Term Survival Between Patients Undergoing Off-Pump and On-Pump Coronary Artery Bypass Graft Operations Giovanni Filardo, PhD, MPH, Paul.

Video-Assisted Thoracic Surgery Lobectomy: Experience With 1,100 Cases

Donald S. Likosky, PhD, Theron A. Paugh, CCP, Steven D

Intraoperative Hemoglobin Levels and Transfusion Independently Predict Stroke After Cardiac Operations Zainab S. Bahrainwala, BS, Maura A. Grega, RN,

Operative Results and Outcomes in Children With Shone's Anomaly

Persistent Effect of Red Cell Transfusion on Health-Related Quality of Life After Cardiac Surgery Colleen Gorman Koch, MD, MS, Farah Khandwala, MS, Liang.

Emergency Coronary Artery Bypass Grafting Can Be Performed Safely Without Cardiopulmonary Bypass in Selected Patients Faraz Kerendi, MD, John D. Puskas,

Transfusion Increases the Risk for Vasoplegia After Cardiac Operations

Simple Index to Predict Likelihood of Skilled Nursing Facility Admission After Coronary Artery Bypass Grafting Among Older Patients David C. Chang, PhD,

Susanne Lison, MD, Michael Spannagl, MD, PhD, Wulf Dietrich, MD, PhD

Pleural Metastasis of Osteosarcoma

Milo Engoren, MD, Thomas A. Schwann, MD, Robert H. Habib, PhD, Sean N

Influence of Mechanical Cell Salvage on Red Blood Cell Aggregation, Deformability, and 2,3-Diphosphoglycerate in Patients Undergoing Cardiac Surgery With.

Who Do You Say You Are? The Annals of Thoracic Surgery

Outcomes Using a Conservative Versus Liberal Red Blood Cell Transfusion Strategy in Infants Requiring Cardiac Operation Jill M. Cholette, MD, Michael.

Acute Kidney Injury and Hemodilution During Cardiopulmonary Bypass: A Changing Scenario Marco Ranucci, MD, FESC, Tommaso Aloisio, MD, Giovanni Carboni,

Use of Amiodarone After Major Lung Resection

A Systematic Review of Biocompatible Cardiopulmonary Bypass Circuits and Clinical Outcome Marco Ranucci, MD, Anna Balduini, AHA, Antonio Ditta, CCP,

Impact of Blood Product Transfusion on Short and Long-Term Survival After Cardiac Surgery: More Evidence Balu Bhaskar, MD, FCICM, Joel Dulhunty, PhD,

Type A Aortic Dissection With Cold Agglutinin Disease

Oxygen Delivery During Cardiopulmonary Bypass and Acute Renal Failure After Coronary Operations Marco Ranucci, MD, Federica Romitti, MD, Giuseppe Isgrò,

Optimal Plasma Transfusion in Patients Undergoing Cardiac Operations With Massive Transfusion Michael A. Mazzeffi, MD, MPH, Evan Chriss, MD, Kathryn.

Abel Gómez-Caro, MD, Pedro Arguis, MD The Annals of Thoracic Surgery

Recurrence and Survival After Segmentectomy in Patients With Prior Lung Resection for Early-Stage Non-Small Cell Lung Cancer Lisa M. Brown, MD, Brian.

Gregory M. Barker, MD, Sean M. O'Brien, PhD, Karl F

Embolized Methyl Methacrylate to the Right Atrium After Kyphoplasty

The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice.

Editorial Board, January 2010

Bradford B. Smith, MD, Matthew A

Red Blood Cell Transfusion Is Associated With Troponin Release After Elective Off- Pump Coronary Artery Bypass Surgery Fausto Biancari, MD, PhD, Eeva-Maija.

Completely Thrombosed Tricuspid Pouch Mimicking a Cardiac Tumor

Bobby Yanagawa, MD, PhD, Rodolfo V

The association of lowest hematocrit during cardiopulmonary bypass with acute renal injury after coronary artery bypass surgery Madhav Swaminathan, MD,

Limitations of Hospital Volume as a Measure of Quality of Care for Coronary Artery Bypass Graft Surgery Karl F. Welke, MD, Mitchell J. Barnett, PharmD,

Risk Factors for Major Complications After Extrapleural Pneumonectomy for Malignant Pleural Mesothelioma Marc de Perrot, MD, Karen McRae, MD, Masaki.

Trends in Patient Characteristics and Outcomes of Coronary Artery Bypass Grafting in the 2000 to 2012 Medicare Population Christian McNeely, MD, Stephen.

“Transitions” for Cardiothoracic Surgeons Now Listed on the Web:

Red Blood Cell Transfusions Impact Pneumonia Rates After Coronary Artery Bypass Grafting Donald S. Likosky, PhD, Gaetano Paone, MD, MHSA, Min Zhang,

Michelle C. Ellis, MD, Theron A. Paugh, CCP, Timothy A

Successful use of argatroban as a heparin substitute during cardiopulmonary bypass: heparin-induced thrombocytopenia in a high-risk cardiac surgical patient

Increased Rehospitalization Rate After Coronary Bypass Operation for Acute Coronary Syndrome: A Prospective Study in 200 Patients Staffan Bjessmo, MD,

Impact of Preoperative Anemia on Outcome in Adult Cardiac Surgery: A Propensity- Matched Analysis Marco Ranucci, MD, FESC, Umberto Di Dedda, MD, Serenella.

Mark I. Block, MD The Annals of Thoracic Surgery

Late Consequences of a Much Earlier Decision

An Assay to Monitor Bivalirudin Levels on Cardiopulmonary Bypass

The Impact of New Technology on Cardiothoracic Surgical Practice

Self-Management of Oral Anticoagulation Therapy Improves Long-Term Survival in Patients With Mechanical Heart Valve Replacement Heinrich Koertke, MD,

Slide Tracheoplasty in Infants and Children: Risk Factors for Prolonged Postoperative Ventilatory Support Peter B. Manning, MD, Michael J. Rutter, MD,

Karl A. Bocchieri, BS, CCP, S. Jacob Scheinerman, MD, L

Safety of low hematocrits during cardiopulmonary bypass

Michelle C. Wallace, MD, James Jaggers, MD, Jennifer S

Presentation transcript:

The Unintended Consequences of Over-Reducing Cardiopulmonary Bypass Circuit Prime Volume Benjamin C. Sun, MD, Timothy A. Dickinson, CCP, Eric A. Tesdahl, PhD, Donald S. Likosky, PhD, Christopher Wells, MD, MBA, Samuel Weinstein, MD The Annals of Thoracic Surgery Volume 103, Issue 6, Pages 1842-1848 (June 2017) DOI: 10.1016/j.athoracsur.2016.09.099 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Model-adjusted probability of packed red blood cells (RBC) transfusion of 1 or more units by prime volume ratio and first hematocrit in the operating room: 32 (solid line) or 40 (dotted line). (Hct = hematocrit; OR = operating room.) The Annals of Thoracic Surgery 2017 103, 1842-1848DOI: (10.1016/j.athoracsur.2016.09.099) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Model A: adjusted odds ratios for transfusion of 1 or more units packed red blood cells. (CPB = cardiopulmonary bypass; Est. = estimated; O.R. = operating room.) The Annals of Thoracic Surgery 2017 103, 1842-1848DOI: (10.1016/j.athoracsur.2016.09.099) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Model-adjusted probability of packed red blood cells (RBC) transfusion of 4 or more units by prime volume ratio and first hematocrit in the operating room: 32 (solid line) or 40 (dotted line). (Hct = hematocrit; OR = operating room.) The Annals of Thoracic Surgery 2017 103, 1842-1848DOI: (10.1016/j.athoracsur.2016.09.099) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Model B: adjusted odds ratios for transfusion of 4 or more units packed red blood cells. (CPB = cardiopulmonary bypass; Est. = estimated; O.R. = operating room.) The Annals of Thoracic Surgery 2017 103, 1842-1848DOI: (10.1016/j.athoracsur.2016.09.099) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Distribution of last the hematocrit in the operating room (O.R.) for the 36,818 patients who did not receive a transfusion. The Annals of Thoracic Surgery 2017 103, 1842-1848DOI: (10.1016/j.athoracsur.2016.09.099) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Supplemental Figure 1 The Annals of Thoracic Surgery 2017 103, 1842-1848DOI: (10.1016/j.athoracsur.2016.09.099) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Supplemental Figure 2 The Annals of Thoracic Surgery 2017 103, 1842-1848DOI: (10.1016/j.athoracsur.2016.09.099) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Supplemental Figure 3 The Annals of Thoracic Surgery 2017 103, 1842-1848DOI: (10.1016/j.athoracsur.2016.09.099) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Supplemental Figure 4 The Annals of Thoracic Surgery 2017 103, 1842-1848DOI: (10.1016/j.athoracsur.2016.09.099) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions