Perioperative Hemoglobin Trajectory in Adult Cardiac Surgical XXXX .

@entity1 @entity8 @entity417
Preoperative @entity417 and nadir hemoglobin (Hb) during cardiopulmonary bypass (CPB) have been identified as significant risk factors for blood transfusion during cardiac surgery. The aim of this study was to confirm the association between @entity417 , perioperative fluid management, and blood transfusion. In addition, the proportion of elective cardiac surgery @entity1 presenting for surgery with @entity417 was identified to examine whether the opportunity exists for timely diagnosis and intervention. Data from referral until hospital discharge were comprehensively reviewed over a 12-month period for all nonemergency cardiac surgical @entity1 operated on in our institution. Of the 342 @entity1 identified, elective cases were referred a median of 35 days before preoperative clinic and operated on a median of 14 days subsequently. Subacute cases had a median of 3 days from referral to surgery. As per the World Health Organization (WHO) criteria for @entity417 , 24.2% of elective and 29.6% of subacute @entity1 were anemic. Blood transfusion was administered to 46.2% of @entity1 during their admission. Transfusion was more likely in @entity1 who were female (odds ratio [OR]: 2.45, 95%confidence interval [CI]: 1.28-4.70), had a low body mass index (BMI) (OR: .89, 95% CI: .84-.94), @entity417 (OR: 5.15, 95% CI: 2.59-10.24), or @entity8 (OR: 5.44, 95% CI: 2.42-12.22). Hemodilution minimization strategies reduced the Hb fall during CPB, but not transfusion rates. This study identifies a high prevalence of @entity417 with sufficient time for elective referrals to undergo appropriate diagnosis and interventions. It also confirms that low red cell mass ( @entity417 and low BMI) and @entity8 are predictors of perioperative blood transfusion. Perfusion strategies to reduce hemodilution are effective at minimizing the intraoperative fall in Hb concentration but did not influence transfusion rate.
