University of Oulu

Tuomas Tauriainen, Eeva-Maija Kinnunen, Joni Koski-Vähälä, Matti-Aleksi Mosorin, Juhani Airaksinen, Fausto Biancari, Outcome after procedures for retained blood syndrome in coronary surgery, European Journal of Cardio-Thoracic Surgery, Volume 51, Issue 6, June 2017, Pages 1078–1085, https://doi.org/10.1093/ejcts/ezx015

Outcome after procedures for retained blood syndrome in coronary surgery

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Author: Tauriainen, Tuomas1; Kinnunen, Eeva-Maija1; Koski-Vähälä, Joni1;
Organizations: 1Department of Surgery, Oulu University Hospital, Oulu, Finland
2Heart Center, Turku University Hospital, Turku, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2019102134018
Language: English
Published: Oxford University Press, 2017
Publish Date: 2019-10-21
Description:

Abstract

OBJECTIVES: Incomplete drainage of blood from around the heart and lungs can lead to retained blood syndrome (RBS) after cardiac surgery. The aim of this study was to assess the incidence of and the outcome after procedures for RBS in patients undergoing isolated coronary artery bypass grafting (CABG).

METHODS: A total of 2764 consecutive patients who underwent isolated CABG from 2006 to 2013 were investigated retrospectively. Patients undergoing any procedure for RBS were compared with patients who did not undergo any procedure for RBS. Multivariate analyses were performed to assess the impact of procedures for RBS on the early outcome.

RESULTS: A total of 254 patients (9.2%) required at least one procedure for RBS. Multivariate analysis showed that RBS requiring a procedure for blood removal was associated with significantly increased 30-day mortality [8.3% vs 2.7%, odds ratio (OR) 2.11, 95% confidence interval (95% CI) 1.15–3.86] rates. Procedures for RBS were independent predictors of the need for postoperative antibiotics (51.6% vs 32.1%, OR 2.08, 95% CI 1.58–2.74), deep sternal wound infection/mediastinitis (6.7% vs 2.2%, OR 3.12, 95% CI 1.72–5.66), Kidney Disease: Improving Global Outcomes acute kidney injury (32.7% vs 15.3%, OR 2.50, 95% CI 1.81–3.46), length of stay in the intensive care unit (mean 8.3 vs 2.0 days, beta 1.74, 95% CI 1.45–2.04) and composite major adverse events (21.3% vs 6.9%, OR 3.24, 95% CI 2.24–4.64). These findings were also confirmed in a subgroup of patients with no pre- or postoperative unstable haemodynamic conditions.

CONCLUSION: RBS requiring any procedure for blood removal from pericardial and pleural spaces is associated with an increased risk of severe complications after isolated CABG.

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Series: European journal of cardio-thoracic surgery
ISSN: 1010-7940
ISSN-E: 1873-734X
ISSN-L: 1010-7940
Volume: 6
Issue: 51
Pages: 1078 - 1085
DOI: 10.1093/ejcts/ezx015
OADOI: https://oadoi.org/10.1093/ejcts/ezx015
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Copyright information: © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. This is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Cardio-Thoracic Surgery following peer review. The version of record [insert complete citation information here] is available online at: https://doi.org/10.1093/ejcts/ezx015.