0
Clinical Investigations: SURGERY |

Transfusion of Blood Components and Postoperative Infection in Patients Undergoing Cardiac Surgery*

Santiago Ramón Leal-Noval, MD; María Dolores Rincón-Ferrari, MD; Andrés García-Curiel, MD; Angel Herruzo-Avilés, MD; Pedro Camacho-Laraña, MD; José Garnacho-Montero, MD; Rosario Amaya-Villar, MD
Author and Funding Information

*From the Critical Care Division (Drs. Leal-Noval, Rincón-Ferrari, Herruzo-Avilés, Camacho-Laraña, Garnacho-Montero, and Amaya-Villar) and the Microbiology Division (Dr. García-Curiel), Hospital Universitario “Virgen del Rocío,” Seville, Spain.

Correspondence to: Santiago Ramón Leal-Noval, MD, Servicio de Cuidados Críticos y Urgencias. Hospital Universitario “Virgen del Rocío,” Avda Manuel Siurot s/n, 41013. Seville, Spain; e-mail: sramon@cica.es



Chest. 2001;119(5):1461-1468. doi:10.1378/chest.119.5.1461
Text Size: A A A
Published online

Objective: To investigate the influence of blood derivatives on the acquisition of severe postoperative infection (SPI) in patients undergoing heart surgery.

Setting: The postoperative ICUs of a tertiary-level university hospital.

Design: A cohort study.

Methods: During a 4-year period, 738 patients, classified as patients with SPIs and patients without SPIs (non-SPI patients), were included in the study. We studied the influence of 36 variables on the development of SPI in general and individually for pneumonia, mediastinitis, and/or septicemia. The influence of the blood derivatives on infections was assessed for RBC concentrates, RBC and plasma, and RBC and platelets.

Results: Seventy patients (9.4%) were classified as having SPIs, and 668 (90.6%) were classified as not having SPIs. After multivariate analysis, the variables associated with SPI (incidence, 9.4%) were reintubation, sternal dehiscence, mechanical ventilation (MV) for ≥ 48 h, reintervention, neurologic dysfunction, transfusion of ≥ 4 U RBCs, and systemic arterial hypotension. The variables associated with nosocomial pneumonia (incidence, 5.9%) were reintubation, MV for ≥ 48 h, neurologic dysfunction, transfusion of ≥ 4 U blood components, and arterial hypotension. The variables associated with mediastinitis (incidence, 2.3%) were reintervention and sternal dehiscence, and those associated with sepsis (incidence, 1.6%) were reintubation, time of bypass ≥ 110 min, and MV for ≥ 48 h. The mortality rate (patients with SPI, 52.8%; non-SPI patients, 8.2%; p < 0.001) and mean (± SD) length of stay in the ICU (patients with SPI, 15.8 ± 12.9 days; non-SPI patients, 4.5 ± 4.4 days; p < 0.001) were greater for the infected patients. The transfused patients also had a greater mortality rate (13.3% vs 8.9%, respectively; p < 0.001) and a longer mean stay in the ICU (6.1 ± 7.2 days vs 3.7 ± 2.8 days, respectively; p < 0.01) than those not transfused.

Conclusion: The administration of blood derivatives, mainly RBCs, was associated in a dose-dependent manner with the development of SPIs, primarily nosocomial pneumonia.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543