Transfusion of 1 and 2 units of red blood cells is associated with increased morbidity and mortality.

Transfusion of 1 and 2 units of red blood cells is associated with increased morbidity and mortality. Ann Thorac Surg. 2014 Jan;97(1):87-94. http://www.sciencedirect.com/science/article/pii/S0003497513016299 http://www.annalsthoracicsurgery.org/article/S0003-4975%2813%2901629-9/abstract Gaetano Paone, Donald S. Likosky, Robert Brewer, Patricia F. Theurer,Gail F. Bell, Chad M. Cogan, Richard L. Prager, Membership of the Michigan Society of Thoracic and Cardiovascular Surgeons The effect of blood transfusion (Tx; 1-2 units only) on mortality after isolated CABG was evaluated in nearly 17,000 pts in Michigan. Operative mortality was 0.5% for no Tx and 1.3% for Tx (p<0.0001). Nine other adverse postoperative outcomes were significantly increased in pts receiving Tx. Aggressive attempts at reducing even small Tx amounts may result in substantial outcomes improvement. 大規模1万7千人！3単位以上は除外。1、2単位の輸血群の成績が悪い。輸血自体が悪いのだろうか？それとも輸血を必要とする状態が悪いのだろうか？例えば出血洗浄自家血の投与は予後を改善するのだろうか？一度、検討してみよう。