Recommendation Table 45.
Recommendations for transfusion management during cardiopulmonary bypass
| Recommendations | Class a | Level b | Ref c |
|---|---|---|---|
| Packed red blood cell transfusions | |||
| It is recommended that PRBCs be transfused during CPB if the HCT value is <18% (Hb 6.0 g/dL). | I | C | - |
| For HCT values between 18% and 24%, PRBCs may be considered based on an assessment of the adequacy of tissue oxygenation. d | IIb | B | 592 |
| PRBCs are not recommended to be transfused during CPB if the HCT is >24% and DO2 and extraction are acceptable. | III | C | 108,587 |
| Fresh frozen plasma transfusions | |||
| It is recommended that antithrombin concentrate be used as the primary treatment of antithrombin deficiency to improve heparin sensitivity. | I | B | 596, 597, 598 |
| If antithrombin concentrate is unavailable, FFP should be considered to treat antithrombin deficiency to improve heparin sensitivity. | IIa | C | - |
| FFP should not be used prophylactically during CPB to reduce perioperative blood loss. | III | B | 599,600 |
CPB: cardiopulmonary bypass; DO2: oxygen delivery; FFP: fresh frozen plasma; Hb: haemoglobin; HCT: haematocrit; PRBC: packed red blood cells.
a
Class of recommendation.
b
Level of evidence.
c
References.
d
The DO2 is maintained at >273 mL/min/m2 and cerebral oximetry is satisfied.