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Willcox et al. 5 Table 2. Cardiopulmonary bypass modifiable factors for patients accepting or refusing blood product transfusion for periods 2007-
2012 and 2013-2018.
Circuit priming volume (mL)
Cell salvage utilisation
Retrograde autologous priming
Retrograde autologous priming volume, mL Haemofiltration
Tranexamic acid
Cardiopulmonary bypass time, minutes Min nasopharyngeal temperature, °C Mean arterial pressure, mmHg
Cardiac index, mL/min/m2
Min haemoglobin, g/L
Min oxygen delivery, mL/min/m2
Max lactate, μmol/L
Any blood product transfusion
Red blood cell transfusion
1,236 (1,049, 1,389) 20%
40%
520 (300, 600)
3% 97%
76 (60, 101) 33.4 (31.9, 34.2)
62 (57, 66) 2.3 (1.9, 2.4) 89 (79, 101)
281 (239, 310) 1.4 (1, 2)
38% 31%
1,212 (1,025, 1,462) 0.81 72% <0.001 45% 0.59 540 (360, 700) 0.70
5% 0.65 100% 0.15
87 (71, 111) 0.076 33.4 (32.2, 34.1) 0.81 64 (59, 66) 0.33 2.3 (1.94, 2.45) 0.98 95 (85, 102) 0.12 287 (259, 324) 0.19 1.5 (1.1, 2) 0.38
0% <0.001 0% <0.001
Accept transfusion Refuse transfusion p
2007-2012
pa
Accept transfusion early vs. late
53 vs. 65 <0.001 0.52
0.21 <0.001 0.49 <0.001
0.36 0.42 0.24 0.45 0.002
<0.001 0.013
0.01 0.012
Refuse transfusion early vs. late
53 vs. 65 <0.001
0.51 0.87 0.032 0.17 0.003 0.042 0.21 0.015 0.12 0.003
<0.001 0.16
N 5353
Circuit priming volume (mL)
Cell salvage utilisation
Retrograde autologous priming
Retrograde autologous priming volume, mL Haemofiltration
Tranexamic acid
Cardiopulmonary bypass time, minutes Min nasopharyngeal temperature, °C Mean arterial pressure, mmHg
Cardiac index, mL/min/m2
Min haemoglobin, g/L
Min oxygen delivery, mL/min/m2
Max lactate, μmol/L
Any blood product transfusion
Red blood cell transfusion
1,610 (1,310, 1,678) 1,596 (1,153, 1,662)
25% 67% <0.001
29%
300 (250, 350) 6%
62%
83 (65, 105)
33.7 (32.4, 34.3) 61 (55, 65)
2.2 (1.97, 2.36) 79 (70, 89)
239 (219, 278) 1.9 (1.35, 2.45)
43% 0.13 350 (250, 400) 0.16 11% 0.30
87% 0.004 75 (52, 102) 0.22 33.7 (32.8, 34.3) 0.79 59 (55, 65) 0.76 2.1 (1.97, 2.29) 0.50
84 (76, 96) 0.049 256 (232, 283) 0.14 1.7 (1.3, 2.6) 0.53
62% 0% <0.001 54% 0% <0.001
0.44
2013-2018
N 6565
Min: minimum; Max: maximum.
Categorical data are represented as % and continuous data as median (interquartile range). aComparison over time periods for patients accepting or refusing transfusion.
There was a significant reduction in circuit prime between the early and late group period for both groups. The volume of retrograde autologous priming (RAP) from the CPB circuit was not different between groups overall and significantly increased in both groups in the later period, which may relate to the observed decreased circuit priming volumes. The use of RAP per se was not different in patients refusing or accepting transfusion overall or within the early or late periods.
Minimum DO2i during CPB was not different between the two groups overall or in either time period;
however, there was a significant increase in DO2i deliv- ered in both groups in time period 2. For the primary determinants of minimum DO2i, average cardiac index and minimum Hb, only minimum Hb was significantly higher in patients refusing transfusion during the early period. Mean arterial pressure (MAP) was not different between groups overall but increased in patients refus- ing transfusion over time.
Outcome data are shown in Table 3 and by time period in Table 4. The primary endpoint of any AKI (creatinine greater than 150% baseline) was significantly
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