Association of primary hemodilution and retrograde autologous priming with transfusion in cardiac surgery: Analysis of the perfusion case database of the Japanese society of extracorporeal technology in medicine

Chihiro Saito, Tetsuya Kamei, Shoji Kubota, Kiyoshi Yoshida, Makoto Hibiya, Shuji Hashimoto

Research output: Contribution to journalArticle

Abstract

It is important to avoid unnecessary blood cell transfusion. However, the associations of hemodilution and retrograde autologous priming with red blood cell transfusion during and after cardiopulmonary bypass (CPB) in cardiac surgery in Japan are currently unclear. We analyzed these associations using data for 3,090 adults from the Perfusion Case Database of the Japanese Society of Extra-Corporeal Technology in Medicine. Percent hemodilution was calculated by total priming volume and weight. Logistic regression models were used to adjust for covariates including type of surgery, gender, age, hemoglobin concentration before CPB, CPB time, urine volume during CPB, and institution. The percentages of red blood cell transfusions during CPB for patients with <15, 15 to <20, 20 to <25, 25 to <30, and $30% hemodilution were 43.0, 51.5, 68.9, 77.3, and 87.7%, respectively. This increase in line with increasing dilution was significant after adjusting for covariates. The percentage of red blood cell transfusion after CPB also increased slightly between 39.0 and 49.4% with percent hemodilution, but the trend after adjusting for covariates was not significant. Use of retrograde autologous priming was significantly associated with blood cell transfusion during CPB after adjusting for covariates, but was not significantly related to blood cell transfusion after CPB. These results suggest that optimizing the percent hemodilution and use of retrograde autologous priming might reduce the use of red blood cell transfusion during CPB in clinical practice in Japan.

Original languageEnglish
Pages (from-to)231-236
Number of pages6
JournalJournal of Extra-Corporeal Technology
Volume50
Issue number4
Publication statusPublished - 01-01-2018

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Hemodilution
Cardiopulmonary Bypass
Thoracic Surgery
Perfusion
Medicine
Databases
Technology
Erythrocyte Transfusion
Blood Transfusion
Blood Cells
Japan
Logistic Models
Hemoglobins
Urine
Weights and Measures

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Health Professions (miscellaneous)
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Association of primary hemodilution and retrograde autologous priming with transfusion in cardiac surgery: Analysis of the perfusion case database of the Japanese society of extracorporeal technology in medicine",
abstract = "It is important to avoid unnecessary blood cell transfusion. However, the associations of hemodilution and retrograde autologous priming with red blood cell transfusion during and after cardiopulmonary bypass (CPB) in cardiac surgery in Japan are currently unclear. We analyzed these associations using data for 3,090 adults from the Perfusion Case Database of the Japanese Society of Extra-Corporeal Technology in Medicine. Percent hemodilution was calculated by total priming volume and weight. Logistic regression models were used to adjust for covariates including type of surgery, gender, age, hemoglobin concentration before CPB, CPB time, urine volume during CPB, and institution. The percentages of red blood cell transfusions during CPB for patients with <15, 15 to <20, 20 to <25, 25 to <30, and $30{\%} hemodilution were 43.0, 51.5, 68.9, 77.3, and 87.7{\%}, respectively. This increase in line with increasing dilution was significant after adjusting for covariates. The percentage of red blood cell transfusion after CPB also increased slightly between 39.0 and 49.4{\%} with percent hemodilution, but the trend after adjusting for covariates was not significant. Use of retrograde autologous priming was significantly associated with blood cell transfusion during CPB after adjusting for covariates, but was not significantly related to blood cell transfusion after CPB. These results suggest that optimizing the percent hemodilution and use of retrograde autologous priming might reduce the use of red blood cell transfusion during CPB in clinical practice in Japan.",
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Association of primary hemodilution and retrograde autologous priming with transfusion in cardiac surgery : Analysis of the perfusion case database of the Japanese society of extracorporeal technology in medicine. / Saito, Chihiro; Kamei, Tetsuya; Kubota, Shoji; Yoshida, Kiyoshi; Hibiya, Makoto; Hashimoto, Shuji.

In: Journal of Extra-Corporeal Technology, Vol. 50, No. 4, 01.01.2018, p. 231-236.

Research output: Contribution to journalArticle

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T2 - Analysis of the perfusion case database of the Japanese society of extracorporeal technology in medicine

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AU - Kamei, Tetsuya

AU - Kubota, Shoji

AU - Yoshida, Kiyoshi

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AU - Hashimoto, Shuji

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