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Open AccessJournal ArticleDOI

Anemia and red blood cell transfusion in critically ill cardiac patients

Geneviève Du Pont-Thibodeau, +2 more
- 02 Jun 2014 - 
- Vol. 4, Iss: 1, pp 16-16
TLDR
The epidemiology of anemia and RBC transfusion in hospitalized adults and children with cardiac disease, and on the outcome of anemic and transfused cardiac patients is reported.
Abstract
Anemia and red blood cell (RBC) transfusion occur frequently in hospitalized patients with cardiac disease. In this narrative review, we report the epidemiology of anemia and RBC transfusion in hospitalized adults and children (excluding premature neonates) with cardiac disease, and on the outcome of anemic and transfused cardiac patients. Both anemia and RBC transfusion are common in cardiac patients, and both are associated with mortality. RBC transfusion is the only way to rapidly treat severe anemia, but is not completely safe. In addition to hemoglobin (Hb) concentration, the determinant(s) that should drive a practitioner to prescribe a RBC transfusion to cardiac patients are currently unclear. In stable acyanotic cardiac patients, Hb level above 70 g/L in children and above 70 to 80 g/L in adults appears safe. In cyanotic children, Hb level above 90 g/L appears safe. The appropriate threshold Hb level for unstable cardiac patients and for children younger than 28 days is unknown. The optimal transfusion strategy in cardiac patients is not well characterized. The threshold at which the risk of anemia outweighs the risk of transfusion is not known. More studies are needed to determine when RBC transfusion is indicated in hospitalized patients with cardiac disease.

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Citations
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Journal ArticleDOI

Patient Blood Management for Neonates and Children Undergoing Cardiac Surgery: 2019 NATA Guidelines

TL;DR: The objective of the task force from the Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis is to provide evidence-based recommendations regarding anemia management and blood transfusion practices in the perioperative care of neonates and children undergoing cardiac surgery, and to highlight potential areas where additional research is urgently required.
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Recommendations on RBC Transfusion in Infants and Children With Acquired and Congenital Heart Disease From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative.

TL;DR: Clinical recommendations emphasize relevant hemoglobin thresholds, and research recommendations emphasize need for further understanding of physiologic and hemoglobin threshold and alternatives to RBC transfusion in subpopulations lacking pediatric literature.
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Bleeding risk with systemic thrombolytic therapy for pulmonary embolism: scope of the problem

TL;DR: The bleeding risk associated with systemic thrombolytic therapy in the management of acute pulmonary embolism is evaluated and strategies to minimize this risk are discussed, including weight-adjusted doses and catheter directed therapy.
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Blood Transfusions After Pediatric Cardiac Operations: A North American Multicenter Prospective Study

TL;DR: This study, which showed great variability in transfusion practices across North American PICUs, highlights the need for clearer transfusion guidelines in this specific population of pediatric cardiac surgical patients.
References
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Journal ArticleDOI

Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock

TL;DR: This study randomly assigned patients who arrived at an urban emergency department with severe sepsis or septic shock to receive either six hours of early goal-directed therapy or standard therapy (as a control) before admission to the intensive care unit.
Journal ArticleDOI

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TL;DR: A restrictive strategy of red-cell transfusion is at least as effective as and possibly superior to a liberal transfusion strategy in critically ill patients, with the possible exception of patients with acute myocardial infarction and unstable angina.
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