[HSF] More Bad News About Trasylol

[hgrmd at aol.com]

Ben,
  This dose dependent reduction in survival after transfusion could be explained by the patient with an acute type A dissection who requires 30 units of blood.  Did the blood transfusions cause his death, or was it the profuse bleeding or hypoperfusion which eventually produced multisystem organ failure?  I think it's extremely difficult to subtract out contributions of other factors in a patient's demise.
Hal 
 
 
-----Original Message-----
From: benjamin.bidstrup at bigpond.com
To: OpenHeart-L at lists.hsforum.com
Sent: Sun, 1 Oct 2006 10:47 AM
Subject: Re: [HSF] More Bad News About Trasylol


>John, 
> I completely agree. It is ridiculous to state that each unit of packed 
>cells increases the mortality 7%. If so, I would have had cases who did fine 
>in spite of a 140% predicted mortality. The 82 yo lady I'm supposed to do 
>tomorrow has a HCT of 34. She needs a redo CABG (1 graft), mitral >and tricuspid 
>repairs. The EF is normal. I suspect I'll use 5 or 6 units of blood. Do 
>you think I just increased her predicted mortality an additional 30% in 
>addition to the inherent 15% risk? Neither do I. 
>Hal 
>_______________________________________________ 
Read the papers. None state that each unit of RBC increases the risk by 7% - but that there is a dose dependent reduction in survival after transfusion. 
-- Ben Bidstrup FRACS FRCSEd FEBCTS 
Consultant Cardiothoracic Surgeon 
_______________________________________________ 
OpenHeart-L mailing list 
 
Send postings to: 
OpenHeart-L at lists.hsforum.com 
 
To UNSUBSCRIBE, to CHANGE email address, or to view archives: 
http://mmp.cjp.com/mailman/listinfo/openheart-l 
 
All messages transmitted by the OpenHeart-L are subject to the policies and disclaimers posted at: 
http://www.hsforum.com/listdisclaim 
----------------------------------------- 
________________________________________________________________________
Check out the new AOL.  Most comprehensive set of free safety and security tools, free access to millions of high-quality videos from across the web, free AOL Mail and more.