Open Access
Table 4
Blood product utilization and fluid management.
| Overall | Year |
p-value | Missing | ||||
|---|---|---|---|---|---|---|---|
| 2019 | 2020 | 2021 | 2022 | ||||
| Number of cases | 40,777 | 10,261 | 9295 | 9731 | 11,490 | ||
| Blood product utilization | |||||||
| Red blood cell units in the prime (% yes) | 1036 (2.5) | 261 (2.5) | 243 (2.6) | 229 (2.4) | 303 (2.6) | 0.569 | 0 |
| Red blood cell units in the prime | 0.0 [0.0, 0.0] | 0.0 [0.0, 0.0] | 0.0 [0.0, 0.0] | 0.0 [0.0, 0.0] | 0.0 [0.0, 0.0] | <0.001 | 33.3 |
| Red blood cell transfusions | <0.001 | 0 | |||||
| None | 26,084 (64.0) | 6825 (66.5) | 5862 (63.1) | 6168 (63.4) | 7229 (62.9) | ||
| Intraoperative only | 2929 (7.2) | 723 (7.0) | 631 (6.8) | 728 (7.5) | 847 (7.4) | ||
| Postoperative only | 7196 (17.6) | 1695 (16.5) | 1691 (18.2) | 1733 (17.8) | 2077 (18.1) | ||
| Intraoperative and postoperative | 4568 (11.2) | 1018 (9.9) | 1111 (12.0) | 1102 (11.3) | 1337 (11.6) | ||
| Hematocrit values, median | |||||||
| First HCT in room | 38.0 [34.0, 42.0] | 38.0 [34.0, 41.0] | 38.0 [34.0, 42.0] | 38.0 [34.0, 42.0] | 38.0 [34.0, 42.0] | <0.001 | 1 |
| Last pre-CPB HCT | 35.0 [30.0, 39.0] | 34.4 [30.0, 38.1] | 34.6 [30.0, 39.0] | 34.8 [30.1, 38.9] | 35.0 [30.6, 39.0] | <0.001 | 3.9 |
| First HCT on CPB | 27.7 [24.0, 31.1] | 27.0 [24.0, 31.0] | 27.7 [24.0, 31.5] | 27.9 [24.0, 31.2] | 28.0 [24.2, 31.2] | <0.001 | 0.3 |
| Nadir HCT on CPB | 26.0 [22.1, 29.2] | 26.0 [22.0, 29.0] | 26.0 [22.0, 29.7] | 26.0 [22.5, 29.4] | 26.0 [22.6, 29.2] | <0.001 | 0.4 |
| Last HCT on CPB | 27.0 [24.0, 30.3] | 27.0 [24.0, 30.0] | 27.0 [24.0, 30.8] | 27.0 [24.0, 30.3] | 27.0 [24.0, 30.2] | <0.001 | 0.4 |
| Prior to first intraoperative transfusion | 21.0 [19.0, 23.0] | 20.0 [19.0, 23.0] | 21.0 [19.0, 23.0] | 21.0 [19.0, 23.0] | 21.0 [19.0, 23.0] | 0.01 | 4.2 |
| Prior to second intraoperative transfusion | 21.0 [19.0, 23.0] | 21.0 [19.0, 24.0] | 21.0 [19.0, 23.0] | 21.0 [19.0, 23.0] | 21.0 [19.0, 24.0] | 0.213 | 11.8 |
| Fluid management | |||||||
| Total pre-bypass perioperative crystalloid volume, median | 900.0 [600.0, 1200.0] | 800.0 [600.0, 1200.0] | 900.0 [600.0, 1200.0] | 900.0 [600.0, 1200.0] | 900.0 [550.0, 1200.0] | 0.003 | 14.4 |
| Total prime volume indexed to body surface area, median | 1110.0 [1060.0, 1185.0] | 1085.0 [1060.0, 1185.0] | 1150.0 [1060.0, 1185.0] | 1085.0 [1010.0, 1185.0] | 1160.0 [1060.0, 1185.0] | 0.001 | 57.8 |
| Retrograde autologous priming | 34,981 (85.8) | 8877 (86.5) | 8072 (86.8) | 8445 (86.8) | 9587 (83.4) | <0.001 | 0 |
| Net prime volume (mL/m2) indexed to BSA | 330.0 [277.8, 403.6] | 321.3 [278.3, 394.9] | 319.5 [268.8, 383.1] | 334.1 [275.8, 406.2] | 349.2 [288.4, 427.9] | <0.001 | 57.8 |
| Acute normovolemic hemodilution | 11,172 (27.4) | 2688 (26.2) | 2297 (24.7) | 2692 (27.7) | 3495 (30.4) | <0.001 | 0 |
| Ultrafiltration | |||||||
| Conventional ultrafiltration | 10,118 (25.2) | 2763 (27.1) | 2261 (24.5) | 2334 (24.2) | 2760 (24.9) | <0.001 | 1.5 |
| Post-cardiopulmonary bypass ultrafiltration | 353 (2.6) | 90 (2.4) | 66 (2.1) | 72 (2.2) | 125 (3.4) | 0.002 | 2.4 |
| Ultrafiltration volume (non-CPB), median | 300.0 [100.0, 500.0] | 300.0 [200.0, 500.0] | 300.0 [137.5, 500.0] | 300.0 [0.0, 500.0] | 300.0 [100.0, 500.0] | 0.679 | 11.0 |
| Ultrafiltration volume (CPB), median | 1500.0 [900.0, 2800.0] | 1600.0 [1000.0, 3000.0] | 1500.0 [900.0, 3000.0] | 1500.0 [800.0, 2700.0] | 1500.0 [825.0, 2500.0] | <0.001 | 1.7 |
| Cardiotomy suction | 36,330 (89.7) | 8689 (85.4) | 8117 (87.7) | 8835 (91.6) | 10,689 (93.5) | <0.001 | 0.6 |
| Autotransfusion | 33,556 (82.8) | 8262 (80.8) | 7743 (83.6) | 8102 (83.8) | 9449 (83.2) | <0.001 | 0.6 |
| Cell salvaged blood transfused, median | 0.0 [0.0, 100.0] | 0.00 [0.0, 225.0] | 0.0 [0.0, 130.0] | 0.0 [0.0, 89.0] | 0.0 [0.0, 0.0] | <0.001 | 14.9 |
| Augmented venous drainage | <0.001 | 0.7 | |||||
| None | 14,455 (35.7) | 4022 (39.6) | 3361 (36.5) | 3581 (37.0) | 3491 (30.5) | ||
| Vacuum | 25,704 (63.5) | 6143 (60.4) | 5853 (63.5) | 6079 (62.9) | 7629 (66.7) | ||
| Kinetic | 337 (0.8) | 3 (0.0) | 4 (0.0) | 8 (0.1) | 322 (2.8) | ||
| Total urine output on CPB (mL/m2), median | 290.0 [170.0, 500.0] | 285.0 [162.8, 485.0] | 280.0 [160.0, 475.0] | 284.5 [170.0, 500.0] | 300.0 [175.0, 500.0] | <0.001 | 2.3 |
Continuous variables are expressed as median, [IQR], and categorical variables as count (%). Abbreviations: HCT, hematocrit; BSA, body surface area; CPB, cardiopulmonary bypass.
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