Transfusions with cardiac surgery could raise the risk of Infection

Fragile balance between the treatment of anemia, avoiding the side effects of the infusion of red blood cells, according to a study

By Mary Elizabeth Dallas

HealthDay Reporter

Thursday, May 30 (HealthDay new) - Les Patients who receive a transfusion of red blood cells during or after heart surgery may be more at risk of infection, according to a new study.

However, the use of platelets during blood transfusion does not seem to pose a similar risk. Limiting the use of red blood cells may result in less post-operative infections, the researchers suggested.

The study is published in the June issue of the Annals of Thoracic Surgery.

"A problem common to many surgeons, and is thus the balance between the risk of anemia induced by surgery with the increased risk of infection when the use of red blood cell transfusion to correct anemia, the patient," study author Dr. Keith Horvath, at the US National Heart, Lung, and Blood Institute, said in a press release from the journal.

"With this study, we hoped to shed light on the problem and to encourage hospitals and surgeons to examine techniques of cell salvage and other alternatives to transfusion [RBC] during and after heart surgery," he said.

The observational study, conducted by the trials cardiothoracic surgery network, involved nearly 5,200 adults who underwent cardiac surgery between February and September 2010.

"Our study part a broad patient population from a number of different institutions that were the subject of any type of cardiac surgery," noted Horvath. "This great set of patient enabled us to better examine the relationship between transfusion and infection in a very diverse population."

Participants of the study, 48% have received a transfusion of red blood cells and platelets of 31 per cent have received.

With transfusions of red blood cells, 84% were held in during a transplant or left ventricular assist device implantation. At the same time, 63% took place during thoracic aortic procedures, 45 percent took place during the derivation of isolated coronary artery graft surgery, and 40% have occurred in isolated valvular surgery.

The study found only 65 days after the surgery, 5 percent of the patients developed at least a major infection, such as pneumonia, colitis c. difficile (a bacterial infection in the colon) and septicemia.

Each unit of transfused red blood cells, there was an increase of 29 percent of risk of infection. On the other hand, transfused platelets with more than four unit of red blood cells has been associated with a lower risk of infection.

"Bit in regulators seized the complex, but actual relations between transfusions of blood cells, infection and... readmissions," Dr. Bruce Spiess, of the Virginia Commonwealth University Medical Center, wrote in a commentary of related journal.

Spiess concluded that improvements in the management of blood in cardiac teams would enhance patient safety, reduce nosocomial infections and reduce the critical blood shortages.

However, the researchers noted that, since it was an observational study, declared associations cannot be considered as a cause and effect relationship.