The impact of an hematocrit of 20% during normothermic cardiopulmonary bypass for elective low risk coronary artery bypass graft surgery on oxygen delivery and clinical outcome – a randomized controlled study [ISRCTN35655335]

Authors

Christian von Heymann, University Hospital Berlin
Michael Sander, University Hospital Berlin
Achim Foer, University Hospital Berlin
Anja Heinemann, University Hospital Berlin
Bruce Spiess, Virginia Commonwealth UniversityFollow
Jan Braun, University Hospital Berlin
Michael Krämer, University Hospital Berlin
Joachim Grosse, University Hospital Berlin
Pascal Dohmen, University Hospital Berlin
Simon Dushe, University Hospital Berlin
Jürgen Halle, University Hospital Berlin
Wolfgang F. Konertz, University Hospital Berlin
Klaus-Dieter Warnecke, University Hospital Berlin
Claudia Spies, University Hospital Berlin

Document Type

Article

Original Publication Date

2006

Journal/Book/Conference Title

Critical Care

Volume

10

Issue

2

DOI of Original Publication

10.1186/cc4891

Comments

Originally published at http://dx.doi.org/10.1186/cc4891

Date of Submission

September 2014

Abstract

Introduction

Cardiopulmonary bypass (CPB) induces hemodilutional anemia, which frequently requires the transfusion of blood products. The objective of this study was to evaluate oxygen delivery and consumption and clinical outcome in low risk patients who were allocated to an hematocrit (Hct) of 20% versus 25% during normothermic CPB for elective coronary artery bypass graft (CABG) surgery.

Methods

This study was a prospective, randomized and controlled trial. Patients were subjected to normothermic CPB (35 to 36°C) and were observed until discharge from the intensive care unit (ICU). Outcome measures were calculated whole body oxygen delivery, oxygen consumption and clinical outcome. A nonparametric multivariate analysis of variance for repeated measurements and small sample sizes was performed.

Results

In a total of 54 patients (25% Hct, n = 28; 20% Hct, n = 26), calculated oxygen delivery (p = 0.11), oxygen consumption (p = 0.06) and blood lactate (p = 0.60) were not significantly different between groups. Clinical outcomes were not different between groups.

Conclusion

These data indicate that an Hct of 20% during normothermic CPB maintained calculated whole body oxygen delivery above a critical level after elective CABG surgery in low risk patients. The question of whether a transfusion trigger in excess of 20% Hct during normothermic CPB is still supported requires a larger prospective and randomized trial.

Rights

© 2006 von Heymann et al., licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Is Part Of

VCU Anesthesiology Publications