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Transfusions With Heart Surgery Might Raise Infection Risk

heartAccording to a new study, patients who receive a during or after may be at greater risk for infection.

However, the use of platelets during transfusions does not appear to carry a similar risk. Limiting red blood cell use could result in fewer major postoperative infections, the researchers suggested.

The study is published in the June issue of the Annals of Thoracic Surgery.

“A common problem for many surgeons, and thereby the patient, is how to balance the risk of surgery-induced anemia with the increased risk of infection when using red blood cell to correct the anemia,” study author Dr. Keith Horvath, at the U.S. National Heart, Lung, and Blood Institute, said in a journal news release.

“Through this study, we hoped to shed light on the problem and to encourage hospitals and surgeons to examine cell-salvage techniques and other alternatives to [red blood cell] transfusion during and after cardiac surgery,” he explained.

The observational study, conducted by the Cardiothoracic Surgical Trials Network, involved nearly 5,200 adults who underwent heart surgery between February and September 2010.

“Our study enrolled a large population of patients from a number of different institutions who were undergoing any type of cardiac surgery,” Horvath noted. “This large patient set enabled us to better examine the relationship between transfusion and infection in a very diverse population.”

Of the study’s participants, 48 percent received a red blood cell transfusion and 31 percent received platelets.

With red blood cell transfusions, 84 percent took place during a transplant or left ventricular assist device implantation. Meanwhile, 63 percent occurred during thoracic aortic procedures, 45 percent took place during isolated coronary artery bypass grafting surgery and 40 percent occurred during isolated valve surgery.

The study found that 65 days after surgery, 5 percent of the patients developed at least one major infection, such as pneumonia, C. difficile (a bacterial infection in the colon) and bloodstream infections.

Having each red blood cell transfused, there ended up being a 29 percent enhance in . In contrast, platelets transfused along with an increase of than four unit connected with red blood cells was of a lower .

“Few within regulatory agencies have grasped the complex but true relationships between red mobile transfusions, infection and… readmissions, inch Dr. Bruce Spiess, from Virginia Commonwealth University Medical, wrote in a associated journal commentary.

Spiess figured improvements in blood supervision among cardiac teams might enhance patient safety, reduce hospital-acquired infections and reduce critical blood shortages.

However, the researchers pointed out that since this is an observational study, the reported associations is not considered as a cause-and-effect connection.

Source: HealthDay News

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