Effect of dilutional anemia that can be treated with only one unit of red blood cell transfusion on tissue oxygenation in cardiac surgery patients

Büşra TEZCAN; Demet BÖLÜKBAŞI; Alev ŞAYLAN; Sema TURAN; Sultan Sevim YAKIN; Dilek KAZANCI; Ayşegül ÖZGÖK; Hija YAZICIOĞLU

Makale detayları

Effect of dilutional anemia that can be treated with only one unit of red blood cell transfusion on tissue oxygenation in cardiac surgery patients

Yazarlar:

Büşra TEZCAN | Demet BÖLÜKBAŞI | Alev ŞAYLAN | Sema TURAN | Sultan Sevim YAKIN | Dilek KAZANCI | Ayşegül ÖZGÖK | Hija YAZICIOĞLU

Yayıncı:

TUBITAK

Dergi:

Turkish Journal of Medical Sciences 2019 Vol.49 Issue 4, pp.1102-1108

Belge Tipi:

Makale

Yayın Tarihi:

7/2019

Belge Dili:

İngilizce

Document ID (Org No.):

2000749996

Sıklık:

İki Aylık

eISSN:

1303-6165

pISSN:

1300-0144

Özet:

 

Background/aim:  Cardiac  surgery,  especially  in  the  presence  of  cardiopulmonary  bypass  (CPB),  is  associated  with  an  inflammatory  reaction  that  may  promote  microcirculatory  alterations,  in  addition  to  the  general  impact  on  system  hemodynamics.  Anemia  and  transfusion make patients more susceptible to the deleterious effects of CPB. In this study, it was aimed to evaluate the effect of dilutional anemia, which is caused by CPB and can be treated with 1?2 units of red blood cell (RBC) transfusion, on global tissue oxygenation parameters in cardiac surgery patients.Materials  and  methods:  This  prospective  observational  study  comprised  127  patients  who  had  a  relatively  stable  operation  period  without any major anesthetic or surgical complications (e.g., operation duration >5 h, bleeding or hemodilution requiring more than 1?2  units  of  RBCs,  or  unstable  hemodynamics,  requiring  inotropic  support  of  more  than  5  ?g/kg/min  dopamine).  Patients  were  observationally divided into two groups: minimally transfused (Group Tr) and nontransfused (Group NTr). Global tissue oxygenation parameters were evaluated after anesthesia induction (T1) and at the end of the operation (T3) and compared between the groups.Results:  Group  Tr  consisted  of  patients  who  had  significantly  lower  preoperative  hemoglobin  values  than  Group  NTr  patients.  The  dilutional anemia of all Group Tr patients could be corrected with 1 unit of RBCs. The lactate levels at T3, increment rates of lactate, and venoarterial carbon dioxide pressure difference (?pCO2) levels [(T3 ? T1) : T1] in Group Tr were significantly higher than those in Group NTr.Conclusion: Dilutional anemia as a result of CPB mostly occurs in patients with borderline preoperative hemoglobin concentrations and  its  correction  with  RBC  transfusion  does  not  normalize  the  degree  of  microcirculatory  and  oxygenation  problems,  which  the  patients are already prone to because of the nature of CPB. Preventing dilutional anemia and transfusion, especially in patients with preoperative borderline hemoglobin levels, may therefore reduce the burden of impaired microcirculation-associated organ failure in on-pump cardiac surgery.

Makale detayları

Effect of dilutional anemia that can be treated with only one unit of red blood cell transfusion on tissue oxygenation in cardiac surgery patients

Yazarlar: Büşra TEZCAN | Demet BÖLÜKBAŞI | Alev ŞAYLAN | Sema TURAN | Sultan Sevim YAKIN | Dilek KAZANCI | Ayşegül ÖZGÖK | Hija YAZICIOĞLU

Yayıncı: TUBITAK

Dergi: Turkish Journal of Medical Sciences 2019 Vol.49 Issue 4, pp.1102-1108

Belge Tipi: Makale

Yayın Tarihi: 7/2019

Belge Dili: İngilizce

Document ID (Org No.): 2000749996

Sıklık: İki Aylık

eISSN: 1303-6165

pISSN: 1300-0144

Sayı

Yazarlar:

Büşra TEZCAN | Demet BÖLÜKBAŞI | Alev ŞAYLAN | Sema TURAN | Sultan Sevim YAKIN | Dilek KAZANCI | Ayşegül ÖZGÖK | Hija YAZICIOĞLU

Yayıncı:

TUBITAK

Dergi:

Turkish Journal of Medical Sciences 2019 Vol.49 Issue 4, pp.1102-1108

Belge Tipi:

Makale

Yayın Tarihi:

7/2019

Belge Dili:

İngilizce

Document ID (Org No.):

2000749996

Sıklık:

İki Aylık

eISSN:

1303-6165

pISSN:

1300-0144