Journal
PERFUSION-UK
Volume 33, Issue 1, Pages 62-70Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/0267659117712405
Keywords
cardiac surgery; acute kidney injury; transfusions; red blood cell; fresh frozen plasma; platelet
Funding
- NIH Medical Research Scholars Program
- NIH
- Pfizer Inc.
- Doris Duke Charitable Foundation
- Alexandria Real Estate Equities, Inc.
- Mr. and Mrs. Joel S. Marcus, and the Howard Hughes Medical Institute
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Introduction: This study explored the nature of the association between intraoperative usage of red blood cell, fresh frozen plasma, cryoprecipitate or platelet transfusions and acute kidney injury. Methods: A total of 1175 patients who underwent cardiac surgery between 2008 and 2013 were retrospectively analyzed. We assessed the association between: (1) preoperative patient characteristics and acute kidney injury, (2) intraoperative blood product usage and acute kidney injury, (3) acute kidney injury and 30-day mortality or re-hospitalization. Results: In our cohort of 1175 patients, 288 patients (24.5%) developed acute kidney injury. This included 162 (13.8%), 69 (5.9%) and 57 (4.9%) developing stage 1, stage 2 or stage 3 acute kidney injury, respectively. Increased red blood cell, fresh frozen plasma or platelet transfusions increased the odds of developing acute kidney injury. Specifically, every unit of red blood cells, fresh frozen plasma or platelets transfused was associated with an increase in the covariate-adjusted odds ratio of developing stage 2 kidney injury of 1.18, 1.19 and 1.04, respectively. Conclusions: Intraoperative blood product transfusions were independently associated with an increased odds of developing acute kidney injury following cardiac surgery. Further randomized studies are needed to better define intraoperative transfusion criteria.
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