Cardiovascular and Thoracic Surgery

The use of allogeneic red blood cells (RBC) is commonplace in cardiac surgery, with reported transfusion rates ranging from 5 to 90 %. Despite advantages, RBC transfusion is associated with well-described adverse outcomes. Transfusion of RBCs is not only associated with an increased perioperative mortality and morbidity, however; it also results in a longer ICU stay, total hospital stay and increased costs. Even the long-term results are influenced by perioperative RBC transfusions. Koch et al. found a significantly reduced 6-month and late survival in patients undergoing an isolated CABG with transfusion of RBCs. Not only the question of RBC transfusion, but also the number of units of transfused RBCs and the method and duration of storage of RBCs is important. It is no surprise that several studies focus on blood conservation methods and a more judicious use of RBCs, with as prerequisite the identification of preoperative variables associated with an increase...