Clinical Trials Logo

Clinical Trial Summary

Observational study.


Clinical Trial Description

Blood transfusion is expensive, and has medical and safety consequences for patients who benefit from it. In cardiac surgery, the data concerning the level of perioperative transfusion are very heterogeneous from one center to another. In a large US cohort study of 798 cardiac surgery centers and 102,470 patients undergoing coronary artery bypass surgery, the rate of blood transfusion varies from 8 to 93% depending on the center. It would appear that the largest and most experienced centers have a blood transfusion rate of around 60%.

In addition to its beneficial role in reducing mortality induced by deep or poorly tolerated anemia, current data from the literature also raise morbidity and mortality related to blood transfusion. Murphy et al. Have shown, in an English cohort of cardiac surgery, that transfusion of CGR was correlated with the occurrence of postoperative infections and ischemic events, as well as early and late excess mortality. These effects appear as early as the first transfused red blood cell, which is confirmed by a prospective Brazilian study with a hazard ratio of death occurrence of 1.2 for each RBC transfused after cardiac surgery.

Preoperative anemia is found in 25% of patients in programmed cardiac surgery and its etiologies are varied. Iron deficiency appears to be at the forefront, especially in coronary patients for whom studies report up to 48% iron deficiency anemia. It may also be vitamin B12 deficiency or folate, chronic pathologies such as renal insufficiency, or any other common cause of anemia.

According to the latest European recommendations, iron deficiency should be defined as <100 ng / mL ferritin or <300 ng / mL ferritin combined with a transferrin saturation <20%.

In cardiac surgery, iron deficiency affects 37% of preoperative patients and is associated with more frequent preoperative and postoperative anemia. It is an independent risk factor for postoperative blood transfusion, even in the absence of preoperatively associated anemia It is currently recommended to seek iron deficiency preoperatively during the discovery of any microcytic anemia and to achieve iron substitution if found. And also to seek supplemental iron deficiency in all patients with cardiac insufficiency. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT03261583
Study type Observational
Source Rennes University Hospital
Contact
Status Completed
Phase
Start date November 14, 2016
Completion date January 15, 2018

See also
  Status Clinical Trial Phase
Recruiting NCT04865874 - GDT-PPV Protocol in Thoracic Surgery N/A
Active, not recruiting NCT02715271 - Study of TB Lesions Obtained in Therapeutical Surgery
Completed NCT02919267 - Physiology of Lung Collapse Under One-Lung Ventilation: Underlying Mechanisms N/A
Completed NCT02964026 - Study of Clinical Outcomes Associated With the Pulmonary Artery Catheter (PAC) in Cardiac Surgery Patients N/A
Recruiting NCT03165539 - Cerebral Oxygen Desaturation and Post-Operative Delirium in Thoracic Surgical Patients
Terminated NCT01320475 - Epidural Levobupivacaine-sufentanil Versus Epidural Levobupivacaine and Intravenous Ketamine Phase 4
Recruiting NCT05045196 - Health-promoting Family Conversations and Open Heart Surgery N/A
Completed NCT04507958 - Electronic Stethoscope Use During Intubation in Full Personal Protective Equipment
Recruiting NCT05060302 - Prognosis of Right Ventricular Dysfunction Assessed by Speckle Tracking in Postoperative Thoracic Surgery N/A
Completed NCT05667467 - The Effect of Care Bundle in Heart Surgery N/A
Not yet recruiting NCT03275428 - THRIVE and Non-intubated Thoracic Surgery N/A
Not yet recruiting NCT05482230 - Application of Tracheal Intubation in Lateral Position in Thoracic Surgery N/A
Enrolling by invitation NCT04429009 - A Randomized Control Trial of ZEPHYRx Gamified Incentive Spirometry Compared to Traditional Spirometry N/A
Not yet recruiting NCT03628040 - Erector Spinae Plane Block for Video-assisted Thoracoscopic Surgery Phase 3
Recruiting NCT03300622 - Assessment in Patients After Thoracic Surgery N/A
Completed NCT00981474 - Cerebral Autoregulation Monitoring During Cardiac Surgery N/A
Completed NCT03309280 - Influence of Different Parameters on Extubation Time After Cardiac Surgery.
Recruiting NCT03820700 - Using Hypnosis and Virtual Reality During Pre and Postoperative Cardiovascular Surgery. N/A
Completed NCT03768193 - Deep Serratus Anterior Plane Block vs Surgically-placed Paravertebral Block for VATS Surgery N/A
Recruiting NCT04609228 - Cardiac Surgery Outcomes in Blood-transfusion Acceptors and no Acceptors