Transfusion
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Randomized Controlled Trial Clinical Trial
Lowering the hemoglobin threshold for transfusion in coronary artery bypass procedures: effect on patient outcome.
There is controversy regarding the application of transfusion triggers in cardiac surgery. The goal of this study was to determine if lowering the hemoglobin threshold for red cell (RBC) transfusion to 8 g per dL after coronary artery bypass graft surgery would reduce blood use without adversely affecting patient outcome. ⋯ A lower Hb threshold of 8 g per dL does not adversely affect patient outcome. Moreover, RBC resources can be saved without increased risk to the patient.
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Donor white cells (WBCs) contained in red cell (RBC) transfusions are thought to provoke down-regulation of T-cell-mediated immunity. This study investigated this topic in otherwise healthy patients receiving buffy coat-depleted or WBC-filtered RBCs and undergoing standardized perioperative management. ⋯ Results of the present study confirm the hypothesis of impaired T-cell-mediated immunity after allogeneic transfusion.