Navigation Links
Heart Surgery Patients Do Fine With Fewer Blood Transfusions: Study
Date:10/12/2010

By Jenifer Goodwin
HealthDay Reporter

TUESDAY, Oct. 12 (HealthDay News) -- Patients having heart surgery who receive fewer blood transfusions do just as well as those who receive more, new research finds, and yet the rate of blood transfusions varies widely among U.S. hospitals.

The studies are published in the Oct. 13 issue of the Journal of the American Medical Association.

In the first study, researchers in Brazil divided 502 cardiac surgery patients into two groups: one received blood transfusions when the hemoglobin concentrations in their blood fell to 30 percent. The other group received blood transfusions when their hemoglobin levels dropped to 24 percent.

Patients who received transfusions at the lower hemoglobin concentration fared just as well in the 30 days after surgery as those who received transfusions at the higher hemoglobin level.

Only 47 percent of patients whose surgeons waited until their blood hemoglobin levels had fallen to 24 percent were given transfusions compared to 78 percent of those in the 30 percent hemoglobin concentration group.

Why should this matter to patients?

Hemoglobin concentration is the percentage of the blood made up of red blood cells. A normal hemoglobin level is about 42 percent, explained Dr. Timothy Gardner, an American Heart Association spokesman and a cardiac surgeon at Christiana Care Health System in Wilmington, Del. Gardner was not involved in the research.

Hemoglobin levels that drop too far can cause severe anemia, which causes the blood to lose too much of its oxygen-carrying capacity and raises the risk of death and other complications.

Yet blood transfusion itself carries risks, Gardner said. Prior research has found an association between transfusions and greater risk of death and problems including renal failure and infection.

"What this study shows is that in patients that don't have a lot of other problems, you don't need to transfuse them to higher levels," Gardner said. "They will do just as well with a lower level of red blood cell concentration during the operative and early postoperative periods."

After blood loss during heart surgery, hemoglobin concentrations usually rebound in about a month or two, Gardner explained.

Yet around the nation, the rate of transfusions during cardiac surgery varies widely, according to a second study in the same journal by researchers from Duke University in Durham, N.C.

Researchers analyzed data on more than 100,000 patients from nearly 800 U.S. hospitals who were getting coronary artery bypass graft surgery for the first time. They found some hospitals transfused almost no one, while other hospitals transfused nearly everyone.

The percentage of patients given red blood cells ranged from 7.8 percent to 92.8 percent; for fresh-frozen plasma, the range was 0 to 97.5 percent, while platelets ranged from 0.4 percent to 90.4 percent, according to the report.

The researchers found no association between post-surgery patient deaths and the hospital's rate of transfusions.

Patients in academic hospitals, hospitals that performed few coronary artery bypass graft operations and hospitals in Texas, Louisiana, Arkansas and Oklahoma were more likely to get transfusions than those in other hospitals, though taken together, those differences accounted for only 11 percent of the variation, the study authors noted.

Patient characteristics, including age and other health conditions, accounted for another 20 percent, they found.

Differences in surgical techniques that lead to more or less bleeding or a culture of transfusing patients routinely may help explain some of the variation, according to the report.

Dr. Lawrence Goodnough, a professor of pathology and medicine at Stanford University who co-authored an accompanying editorial, said the findings suggest that transfusion rates should be one factor taken into account when rating hospital performance.

"Blood transfusions should be a quality indicator that can help track how carefully surgical patients are being handled," Goodnough said.

Taken together, the studies suggest hospitals may need to rethink their transfusion practices, Gardner said, noting that in some patients transfusing to the higher hemoglobin level is appropriate.

"The combination of the two articles is forcing heart surgeons to reconsider their transfusion practices during heart surgery," Gardner said. "The Brazilian study suggests we can safely treat many patients without transfusion. The other study shows that as a community of heart surgeons, there is still a lot of variation in practices. It's a double whammy."

More information

The U.S. National Heart, Lung, and Blood Institute has more on blood transfusions.

SOURCES: Timothy J. Gardner, M.D., American Heart Association spokesman, and medical director, Center for Heart & Vascular Health, Christiana Care Health System in Wilmington, Del.; Lawrence Goodnough, M.D., professor, pathology and medicine, and director, transfusion service, Stanford Medical Center, Palo Alto, Calif.; Oct. 13, 2010, Journal of the American Medical Association


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Medical researchers break down costs to care for heart failure patients at the end of life
2. End-of-life care patterns shift for patients with heart failure in both US and Canada
3. Certain new therapies for age-related eye disease do not appear to increase heart risks
4. No Heart Benefit Seen From Folic Acid Supplements
5. Heartburn Drugs, Plavix Seem Safe to Take Together
6. Once-Promising Heart Failure Drug Fails in Trial
7. Workplace Noise Tied to Heart Disease Risk
8. Testosterone Could Boost Health of Heart Failure Patients
9. Dental Care Linked to Heart Health in Older Women
10. Heart, kidney, diabetes and cancer MEP groups league against chronic disease to seek European commitment
11. Women who get dental care have lower risk of heart disease, says study
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Heart Surgery Patients Do Fine With Fewer Blood Transfusions: Study
(Date:12/9/2016)... (PRWEB) , ... December 09, 2016 , ... ... whiteboard display solutions, proudly announced today that a new solution for Emergency Departments ... fit in the tight space in Emergency Department examination rooms, and with a ...
(Date:12/8/2016)... Cambridge, MA (PRWEB) , ... December 08, 2016 ... ... the Workers Compensation Research Institute (WCRI) officially opened registration today for its ... Place Hotel in Boston, MA . , The theme of the conference is ...
(Date:12/8/2016)... ... December 08, 2016 , ... CURE Media Group, the nation’s leading digital ... aligned with Upstage Lung Cancer in efforts to combat lung cancer, announced CURE Media ... Jr said, “CURE Media Group is honored to team up with Upstage Lung Cancer ...
(Date:12/8/2016)... (PRWEB) , ... December 08, ... ... Presence Suite 10.2 version gives development continuity to its innovative Unified Instance ... channels management capacity. In addition, this new version optimizes the unattended auto-dialing ...
(Date:12/8/2016)... ... December 08, 2016 , ... Today’s patients are encouraged ... in mind, SIGVARIS has created a new line of anti-embolism stockings to help ... provide the benefits of graduated compression when transitioning from recovery to early rehabilitation. ...
Breaking Medicine News(10 mins):
(Date:12/8/2016)... 8, 2016 KEY FINDINGS ... of the market in 2016 and is expected to ... attributed to a large number of surgical procedures that ... largest share in the patient temperature management market.) Patient ... reducing loss of blood during surgeries, lowering the risks ...
(Date:12/8/2016)... Research and Markets has announced the addition ... Adhesion Type, Application, Usability - Forecast to 2025" report to ... , , ... poised to grow at a CAGR of around 3.2% from 2015 ... witnessing include advancements in extracellular microelectrode arrays and intracellular microelectrodes, research ...
(Date:12/8/2016)... 2016  Valeant Pharmaceuticals International, Inc. (NYSE: ... announced positive results from a Phase 3, multicenter ... safety and efficacy of IDP-118 (halobetasol propionate and ... Within the Phase 3 study ... psoriasis, IDP-118 showed statistical significance to vehicle with ...
Breaking Medicine Technology: