Assessment of RBC transfusion volume and its effect on postoperative pulmonary complications in on-pump CABG patients / 中国实验血液学杂志

ABSTRACT

This study was purposed to investigate the effect of the transfused RBC amount on pulmonary complications after on-pump CABG surgery, and to explore the influencing factors on RBC transfusion volume. 292 adult patients receiving on-pump CABG surgery were divided into non-RBC transfusion group (n = 71), 1-4 U RBC transfusion group (n = 144) and >4 U RBC transfusion group (n = 77). Adjusted multivariable regression analysis was performed to examine the correlation between transfused RBC amount and the odds of pulmonary complications, and multivariable linear regression was used to analyze the influencing factors on RBC transfusion volume. The results showed that compared the three groups, there was the significant difference in postoperative pulmonary complications (1.4% vs 14.6% vs 24.7%, P < 0.001). A stronger and graded correlation was found between transfused RBC amount and pulmonary complications in on-pump CABG patients, the adjusted odds were increased to 1.251 (95% CI 1.120-1.398, P < 0.001), and influencing factors on RBC transfusion volume were as follows age (B0.102; 95% CI 0.046-0.157, P < 0.001), sex (B1.825; 95% CI 0.692-2.957, P = 0.002), preoperative Hct (B-36.044; 95% CI-47.724--25.163, P < 0.001), CPB time (B 0.031; 95% CI0.013-0.050, P = 0.001) and acute myocardiac infarction (B2.769; 95% CI 1.295-4.243, P < 0.001). It is concluded that the transfused RBC amount is related with postoperative pulmonary complications, and the influencing factors on RBC transfusion volume include preoperative Hct, age, acute myocardiac infarction, sex and CPB time.