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Please use this identifier to cite or link to this item: http://hdl.handle.net/11055/610
Title: Anticoagulation, bleeding and blood transfusion practices in Australasian cardiac surgical practice.
Authors: Daly, DJ
Myles, PS
Smith, JA
Knight, JL
Clavisi, O
Bain, DL
Glew, R
Gibbs, NM
Merry, AE
ANZCA Clinical Trials Network
ANZCA/FPM Author: ANZCA Clinical Trials Network
Merry, AF
Smith, John Anthony
Daly, DJ
Issue Date: Oct-2007
Citation: 35(5):760-8.
Abstract: We surveyed contemporary Australasian cardiac surgical and anaesthetic practice, focusing on antiplatelet and antifibrinolytic therapies and blood transfusion practices. The cohort included 499 sequential adult cardiac surgical patients in 12 Australasian teaching hospitals. A total of 282 (57%) patients received red cell or component transfusion. The median (IQR) red cell transfusion threshold haemogloblin levels were 66 (61-73) g/l intraoperatively and 79 (74-85) g/l postoperatively. Many (40%) patients had aspirin within five days of surgery but this was not associated with blood loss or transfusion; 15% had clopidogrel within seven days of surgery. In all, 30 patients (6%) required surgical re-exploration for bleeding. Factors associated with transfusion and excessive bleeding include pre-existing renal impairment, preoperative clopidogrel therapy, and complex or emergency surgery. Despite frequent (67%) use of antifibrinolytic therapy, there was a marked variability in red cell transfusion rates between centres (range 17 to 79%, P < 0.001). This suggests opportunities for improvement in implementation of guidelines and effective blood-sparing interventions. Many patients presenting for surgery receive antiplatelet and/or antifibrinolytic therapy, yet the subsequent benefits and risks remain unclear.
URI: http://hdl.handle.net/11055/610
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/17933164
Journal Title: Anaesthesia and Intensive Care
Type: Journal Article
Study/Trial: Survey
Appears in Collections:Scholarly and Clinical

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