Ann Vasc Med | Volume 2, Issue 1 | Review Article | Open Access
Laila Cunin1*, Charannya Balakumar2, Lauren Kennedy1, Ayeshah Gordon-Dixon2, Jaswarlal Senaratne1 and Thomas Rix1
1Department of Vascular Surgery, East Kent Hospitals University NHS Foundation Trust, UK
2Department of General Surgery, East Kent Hospitals University NHS Foundation Trust, UK
*Correspondance to: Laila Cunin
Fulltext PDFIntroduction: The negative effect of Blood Transfusion (BT) in patients undergoing cardiac surgery has been demonstrated within the literature extensively. This review aims to answer the question whether the emerging new evidence suggests that transfusion is harmful to the vascular surgery patient and whether we should re-consider our previous liberal approach to transfusion.
Methods: A review of the literature using the Pubmed search engine was performed where 476 articles were found, of these 23 were found to be relevant, search terms included “Blood transfusion” AND “Vascular surgery”. A review of the literature over the last 5 years was performed; exclusion criteria were any articles not available in English. A standard proforma was used to assess each scientific article.
Results: The literature suggests that blood transfusion increases mortality and morbidity. In 2014 Curley et al. published a systematic review and meta-analysis showing no statistically significant effect between restrictive versus liberal triggers for transfusion, however there was major morbidity associated with a more liberal transfusion approach. Studies have shown BT increases re admission rates, increases surgical site infection and graft thrombosis.
Conclusion: From the literature it can be stated that BT increased morbidity and mortality independently of anaemia and that it should not be undertaken lightly. A restrictive approach at present is advocated in the current literature, however this review highlights the limited evidence available and the need for a large RCT to assess nadir Hb level for transfusion in vascular surgery patients.
Cunin L, Balakumar C, Kennedy L, Gordon-Dixon A, Senaratne J, Rix T. A Review of ‘The Implications of Perioperative Blood Transfusion in Patients Undergoing Vascular Surgery’. Ann Vasc Med. 2019;2(1):1009.