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Master Thesis

Évolution du profil de l’acte transfusionnel en chirurgie cardiaque sous circulation extracorporelle : étude rétrospective sur 6 ans

Abstract : Introduction: cardiac surgery is associated with a high transfusion rate. Preoperative anaemia is common and causes an increase in postoperative poor outcomes and mortality. Transfusion in blood products is also associated with complications. Despite guidelines which suggests low transfusion threshold and restrictive attitude transfusion rate remains high. The main objective of our study was to assess the evolution of transfusion rate over different periods. Secondary we assess changes in trend of products used, in rate in complications and abusive transfusion. Materials and Method: it was a monocentric, retrospective study based on PESSAC database of cardiac surgery ICU which contained clinical and biological characteristics of patients who underwent cardiac surgery under cardiopulmonary bypass. We included all patients of the first four month of each year between 2011 and 2016. Results: 2534 patients underwent cardiac surgery on the study period. 1826 patients (72,6%) were transfused with blood products. Among them 91,9% received at least one RBC, 30,3% one FFP, 43,9% on PLT and 38,4% a plasma derived product (prothrombin cryoprecipitate complex or fibrinogen). Massive transfusion represented 21,8% of patients and abusive transfusion 27,3% with a total of 931 units of RBC. Overall mortality was 1,8%. Discussion: a large part of patients received allogenic transfusion whether it was to oxygen transport or to haemostatic goal, more than described in literature even it was heterogenous. Abusive transfusion was also common. We did not see high rate in thrombotic complications or death. Conclusion: transfusion was common an abusive, and attempt should aim to improve patient blood management.
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https://dumas.ccsd.cnrs.fr/dumas-02431034
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Submitted on : Tuesday, January 7, 2020 - 4:40:56 PM
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Thibaud Besnard. Évolution du profil de l’acte transfusionnel en chirurgie cardiaque sous circulation extracorporelle : étude rétrospective sur 6 ans. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02431034⟩

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