Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital

Effect of low vs. high haemoglobin transfusion trigger on cardiac output in patients undergoing elective vascular surgery: Post-hoc analysis of a randomized trial

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


  1. Hypophosphataemia is common in patients with aneurysmal subarachnoid haemorrhage

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Bioimpedance as a measure of fluid status in critically ill patients: A systematic review

    Publikation: Bidrag til tidsskriftReviewForskningpeer review

  3. Effect of immunoglobulin G on cytokine response in necrotising soft-tissue infection: a post-hoc analysis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Ischaemic vascular disease and long-term mortality in emergency abdominal surgical patients: A population-based cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Phrenic Nerve Block on Severe Post-Hepatectomy Shoulder Pain: A Randomized, Double-blind, Placebo-controlled, Pilot Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. A new tool to assess Clinical Diversity In Meta-analyses (CDIM) of interventions

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Assessment of assumptions of statistical analysis methods in randomised clinical trials: the what and how

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Considerations on the strengths and limitations of using disease-related mortality as an outcome in clinical research

    Publikation: Bidrag til tidsskriftKommentar/debatForskningpeer review

  • Anders Møller
  • Jørn Wetterslev
  • Saeid Shahidi
  • Dorthe Hellemann
  • Niels H Secher
  • Ole B Pedersen
  • Klaus V Marcussen
  • Benedicte G U Ramsing
  • Anette Mortensen
  • Henning B Nielsen
Vis graf over relationer

BACKGROUND: During vascular surgery, restricted red-cell transfusion reduces frontal lobe oxygen (ScO 2 ) saturation as determined by near-infrared spectroscopy. We evaluated whether inadequate increase in cardiac output (CO) following haemodilution explains reduction in ScO 2 .

METHODS: This is a post-hoc analysis of data from the Transfusion in Vascular surgery (TV) Trial where patients were randomized on haemoglobin drop below 9.7 g/dL to red-cell transfusion at haemoglobin below 8.0 (low-trigger) vs 9.7 g/dL (high-trigger). Fluid administration was guided by optimizing stroke volume. We compared mean intraoperative levels of CO, haemoglobin, oxygen delivery, and CO at nadir ScO 2 with linear regression adjusted for age, operation type and baseline. Data for 46 patients randomized before end of surgery were included for analysis.

RESULTS: The low-trigger resulted in a 7.1% lower mean intraoperative haemoglobin level (mean difference, -0.74 g/dL; P < .001) and reduced volume of red-cell transfused (median [inter-quartile range], 0 [0-300] vs 450 mL [300-675]; P < .001) compared with the high-trigger group. Mean CO during surgery was numerically 7.3% higher in the low-trigger compared with the high-trigger group (mean difference, 0.36 L/min; 95% confidence interval (CI.95), -0.05 to 0.78; P = .092; n = 42). At the nadir ScO 2 -level, CO was 11.9% higher in the low-trigger group (mean difference, 0.58 L/min; CI.95, 0.10-1.07; P = .024). No difference in oxygen delivery was detected between trial groups (MD, 1.39 dL O2 /min; CI.95, -6.16 to 8.93; P = .721).

CONCLUSION: Vascular surgical patients exposed to restrictive RBC transfusion elicit the expected increase in CO making it unlikely that their potentially limited cardiac capacity explains the associated ScO 2 decrease.

TidsskriftActa Anaesthesiologica Scandinavica
Udgave nummer3
Sider (fra-til)302-312
Antal sider11
StatusUdgivet - mar. 2021

ID: 61311766