Post-operative atrial fibrillation, intraoperative autologous blood salvage and transfusion in cardiac surgery.

BACKGROUND AND

OBJECTIVES

Postoperative atrial fibrillation is the most common complication following cardiac surgical procedures. The objective of this study was to assess a possible association of postoperative atrial fibrillation, intraoperative autologous blood salvage, and blood transfusion.

METHODS

A total of 357 adult patients undergoing cardiac surgery with the use of intraoperative autologous blood salvage were included. They were divided into two groups: one with 161 patients (45%) who only received their recovered autologous blood, and another with 196 patients (55%) who additionally required the transfusion of homologous blood components. Demographic data, pre- and post-operative laboratory parameters, transfusion profiles, and clinical outcomes (mortality) were compared.

RESULTS

The number of recovered autologous blood units was not associated with an increased risk of postoperative arrhythmia (Odds ratio: 0.75; 95% CI: 0.45-1.11). Intraoperative homologous blood transfusion was associated with a significantly increased risk of death (Hazard ratio: 5.17; 95% CI 1.44-18.56). When autologous salvaged blood volume and homologous components were evaluated together, homologous transfusion was associated with higher risk of postoperative atrial fibrillation (Odds ratio: 2.51, 95% CI 1.18-5.65), whereas number of autologous units was not (OR 0.66, 95% CI 0.39-1.01). Transfusion at any time point (intraoperative, intensive care unit [ICU], or ward) was also associated with an increased risk of death (Hazard ratio: 5.15, 95% CI 1.16-22.94).

CONCLUSION

While advanced age was significantly associated with postoperative atrial fibrillation, no association was found with intraoperative autologous blood salvage and blood transfusion.