tailieunhanh - Báo cáo y học: "Intra-operative intravenous fluid restriction reduces perioperative red blood cell transfusion in elective cardiac surgery, especially in transfusion-prone patients: a prospective, randomized controlled trial"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Intra-operative intravenous fluid restriction reduces perioperative red blood cell transfusion in elective cardiac surgery, especially in transfusion-prone patients: a prospective, randomized controlled trial. | Vretzakis et al. Journal of Cardiothoracic Surgery 2010 5 7 http content 5 1 7 JOTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Intra-operative intravenous fluid restriction reduces perioperative red blood cell transfusion in elective cardiac surgery especially in transfusion-prone patients a prospective randomized controlled trial 11 11 1 George Vretzakis Athina Kleitsaki Konstantinos Stamoulis Metaxia Bareka Stavroula Georgopoulou Menelaos Karanikolas 2 Athanasios Giannoukas3 Abstract Background Cardiac surgery is a major consumer of blood products and hemodilution increases transfusion requirements during cardiac surgery under CPB. As intraoperative parenteral fluids contribute to hemodilution we evaluated the hypothesis that intraoperative fluid restriction reduces packed red-cell PRC use especially in transfusion-prone adults undergoing elective cardiac surgery. Methods 192 patients were randomly assigned to restrictive group A 100 pts or liberal group B 92 pts intraoperative intravenous fluid administration. All operations were conducted by the same team same surgeon and perfusionist . After anesthesia induction intravenous fluids were turned off in Group A fluid restriction patients who only received fluids if directed by protocol. In contrast intravenous fluid administration was unrestricted in group B. Transfusion decisions were made by the attending anesthesiologist based on identical transfusion guidelines for both groups. Results 137 of 192 patients received 289 PRC units in total. Age sex weight height BMI BSA LVEF CPB duration and surgery duration did not differ between groups. Fluid balance was less positive in Group A. Fewer group A patients 62 100 required transfusion compared to group B 75 92 p . Group A patients received fewer PRC units 113 compared to group B 176 p . Intraoperatively the number of transfused units and transfused patients was lower in group A 31 u in 19 pts vs. 111 u in