BACKGROUND: Mediastinitis, a serious complication after cardiac surgery, increases morbidity, mortality, and cost of care. Accumulating evidence implicates blood transfusions in the development of mediastinitis. OBJECTIVES: We conducted a systematic review to evaluate the association between allogeneic blood transfusion and mediastinitis in adult cardiac surgery patients. RESULTS: After a search of Medline, PubMed, Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature, and the Institute for Scientific Information's Web of Knowledge (1990-2010) for relevant studies, 7 (3 prospective cohort and 4 retrospective reviews) met our inclusion/exclusion criteria. Between 20% and 80.2% of patients received blood transfusions, with an incidence of mediastinitis ranging from 0.1% to 2.3%. Five studies demonstrated an independent association between red blood cell transfusion and mediastinitis. Two studies identified a dose-response relationship. CONCLUSION: The findings of this systematic review suggest that allogeneic red blood cell transfusions are associated with an increased risk of mediastinitis in patients undergoing cardiac surgery. Individual risks and benefits should be assessed in each patient before a red blood cell transfusion.
BACKGROUND:Mediastinitis, a serious complication after cardiac surgery, increases morbidity, mortality, and cost of care. Accumulating evidence implicates blood transfusions in the development of mediastinitis. OBJECTIVES: We conducted a systematic review to evaluate the association between allogeneic blood transfusion and mediastinitis in adult cardiac surgery patients. RESULTS: After a search of Medline, PubMed, Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature, and the Institute for Scientific Information's Web of Knowledge (1990-2010) for relevant studies, 7 (3 prospective cohort and 4 retrospective reviews) met our inclusion/exclusion criteria. Between 20% and 80.2% of patients received blood transfusions, with an incidence of mediastinitis ranging from 0.1% to 2.3%. Five studies demonstrated an independent association between red blood cell transfusion and mediastinitis. Two studies identified a dose-response relationship. CONCLUSION: The findings of this systematic review suggest that allogeneic red blood cell transfusions are associated with an increased risk of mediastinitis in patients undergoing cardiac surgery. Individual risks and benefits should be assessed in each patient before a red blood cell transfusion.
Authors: Edgar Hernández Leiva; Marisol Carreño; Fernando Rada Bucheli; Alberto Cadena Bonfanti; Juan Pablo Umaña; Rodolfo José Dennis Journal: Ann Card Anaesth Date: 2018 Apr-Jun
Authors: Pedro Gabriel Melo de Barros E Silva; Dimas Tadahiro Ikeoka; Viviane Aparecida Fernandes; Nilza Sandra Lasta; Debora Prudencio E Silva; Mariana Yumi Okada; Beatriz Akinaga Izidoro; José Carlos Teixeira Garcia; Antonio Claudio do Amaral Baruzzi; Valter Furlan Journal: Einstein (Sao Paulo) Date: 2013 Jul-Sep
Authors: Jussara Aparecida Souza do Nascimento Rodrigues; Renata Eloah de Lucena Ferretti-Rebustini; Vanessa de Brito Poveda Journal: Rev Lat Am Enfermagem Date: 2016-08-29
Authors: Yanjuan Huang; Yi Liang; He Ma; Mei Ling; Xuelian Ran; Jingxian Huang; Kejian Lu; Risheng Zhong; Fanke Huang; Wenwu Bin Journal: Biomed Res Int Date: 2017-11-16 Impact factor: 3.411
Authors: Shaikhah Awadh Al-Harbi; Noura Alkhayal; Afrah Alsehali; Shatha Alshaya; Wesam Bin Obaid; Alaa Althubaiti; R E van Onselen; Mohmed Al Annany; Ahmed A Arifi Journal: J Saudi Heart Assoc Date: 2019-07-02