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Reducing the immediate availability of red blood cells in cardiac surgery, a single-centre experience

(2015) NETHERLANDS HEART JOURNAL. 23(1). p.28-32
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Organization
Abstract
Background: In our institution, we have redefined our criteria for direct availability of red blood cell (RBC) units in the operation room. In this study, we sought to evaluate the safety of applying this new logistical policy of blood transfusion in the first preliminary group of patients. Methods: In March 2010, we started a new policy concerning the elective availability of RBC units in the operation room. This policy was called: No Elective Red Cells (NERC) program. The program was applied for patients undergoing primary isolated coronary artery bypass grafting (CABG) or single valve surgery. No elective RBC units were preoperatively ordered for these patients. In case of urgent need, blood was delivered to the operating room within 20 min. The present study includes the first 500 patients who were managed according to this policy. Logistic regression analyses were performed to investigate the impact of biomedical variables on fulfilling this NERC program. Results: The majority of patients (n=409, 81 %) did not receive any RBCs during the hospital stay. In patients who did receive RBCs (n=91, 19 %), 11 patients (2.2 %) received RBCs after 24 h postoperatively. Female gender, left ventricular ejection fraction (LVEF) and EuroSCORE were significant predictors for the need of blood transfusion (OR=3.12; 2.79; 1.17 respectively). Conclusion: In a selected group of patients, it is safe to perform cardiac surgery without the immediate availability of RBCs in the operating room. Transfusion was avoided in 81 % of these patients. Female gender, LVEF and EuroSCORE were associated with blood transfusion.
Keywords
DURATION, COMPLICATIONS, MORBIDITY, MORTALITY, Cardiac surgery, Red blood cells, Transfusion, LONG-TERM SURVIVAL, IMPACT, STORAGE, TRANSFUSION

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MLA
Haanschoten, MC et al. “Reducing the Immediate Availability of Red Blood Cells in Cardiac Surgery, a Single-centre Experience.” NETHERLANDS HEART JOURNAL 23.1 (2015): 28–32. Print.
APA
Haanschoten, M., van Straten, A., Verstappen, F., van de Kerkhof, D., Van Zundert, A., & Hamad, M. S. (2015). Reducing the immediate availability of red blood cells in cardiac surgery, a single-centre experience. NETHERLANDS HEART JOURNAL, 23(1), 28–32.
Chicago author-date
Haanschoten, MC, AHM van Straten, F Verstappen, D van de Kerkhof, Adrien Van Zundert, and MA Soliman Hamad. 2015. “Reducing the Immediate Availability of Red Blood Cells in Cardiac Surgery, a Single-centre Experience.” Netherlands Heart Journal 23 (1): 28–32.
Chicago author-date (all authors)
Haanschoten, MC, AHM van Straten, F Verstappen, D van de Kerkhof, Adrien Van Zundert, and MA Soliman Hamad. 2015. “Reducing the Immediate Availability of Red Blood Cells in Cardiac Surgery, a Single-centre Experience.” Netherlands Heart Journal 23 (1): 28–32.
Vancouver
1.
Haanschoten M, van Straten A, Verstappen F, van de Kerkhof D, Van Zundert A, Hamad MS. Reducing the immediate availability of red blood cells in cardiac surgery, a single-centre experience. NETHERLANDS HEART JOURNAL. 2015;23(1):28–32.
IEEE
[1]
M. Haanschoten, A. van Straten, F. Verstappen, D. van de Kerkhof, A. Van Zundert, and M. S. Hamad, “Reducing the immediate availability of red blood cells in cardiac surgery, a single-centre experience,” NETHERLANDS HEART JOURNAL, vol. 23, no. 1, pp. 28–32, 2015.
@article{5853231,
  abstract     = {Background: In our institution, we have redefined our criteria for direct availability of red blood cell (RBC) units in the operation room. In this study, we sought to evaluate the safety of applying this new logistical policy of blood transfusion in the first preliminary group of patients. 
Methods: In March 2010, we started a new policy concerning the elective availability of RBC units in the operation room. This policy was called: No Elective Red Cells (NERC) program. The program was applied for patients undergoing primary isolated coronary artery bypass grafting (CABG) or single valve surgery. No elective RBC units were preoperatively ordered for these patients. In case of urgent need, blood was delivered to the operating room within 20 min. The present study includes the first 500 patients who were managed according to this policy. Logistic regression analyses were performed to investigate the impact of biomedical variables on fulfilling this NERC program. 
Results: The majority of patients (n=409, 81 %) did not receive any RBCs during the hospital stay. In patients who did receive RBCs (n=91, 19 %), 11 patients (2.2 %) received RBCs after 24 h postoperatively. Female gender, left ventricular ejection fraction (LVEF) and EuroSCORE were significant predictors for the need of blood transfusion (OR=3.12; 2.79; 1.17 respectively). 
Conclusion: In a selected group of patients, it is safe to perform cardiac surgery without the immediate availability of RBCs in the operating room. Transfusion was avoided in 81 % of these patients. Female gender, LVEF and EuroSCORE were associated with blood transfusion.},
  author       = {Haanschoten, MC and van Straten, AHM and Verstappen, F and van de Kerkhof, D and Van Zundert, Adrien and Hamad, MA Soliman},
  issn         = {1568-5888},
  journal      = {NETHERLANDS HEART JOURNAL},
  keywords     = {DURATION,COMPLICATIONS,MORBIDITY,MORTALITY,Cardiac surgery,Red blood cells,Transfusion,LONG-TERM SURVIVAL,IMPACT,STORAGE,TRANSFUSION},
  language     = {eng},
  number       = {1},
  pages        = {28--32},
  title        = {Reducing the immediate availability of red blood cells in cardiac surgery, a single-centre experience},
  url          = {http://dx.doi.org/10.1007/s12471-014-0618-9},
  volume       = {23},
  year         = {2015},
}

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