Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Blood transfusion study: Less is more

A new study suggests that blood transfusions for hospitalized cardiac patients should be a last resort because they double the risk of infection and increase by four times the risk of death.

The analysis of nearly 25,000 Medicare patients in Michigan also showed that transfusion practices after heart surgery varied substantially among hospitals, a red flag that plays into the health care reform debate.

A wide variation in care is a hot-button issue, as lawmakers and health reform experts discuss the best ways to address the variations. Some experts believe the country needs a system of medical guidelines, supported by scientific evidence, to aid doctors in decision-making. In fact, the Institute of Medicine has called for a national initiative of comparing the benefits and harms of certain methods to improve the delivery of care -- an effort referred to by health-care insiders as "comparative effectiveness" research.

Blood transfusion is an area that could be well served with stronger, research-based guidelines, since the current clinical practice is all over the map, said study co-author Neil Blumberg, M.D., professor of Pathology and Laboratory Medicine and director of Transfusion Medicine at the University of Rochester Medical Center.

"Doctors are simply doing what they were trained to do, but it turns out that their actions are more harmful than helpful in many cases," Blumberg said. "This is an instance in which clinical practice got way ahead of research. And changing the liberal use of transfusions is going to be difficult despite the evidence showing it is usually not essential."

The study was published July 31, 2009 in the journal, BMC Medicine. It was designed to assess patient outcomes as well as hospital variation in blood use.

Blumberg and lead author Mary Rogers, Ph.D., of the University of Michigan Health System, analyzed patient records in 40 hospitals, from admission to 30 days after discharge. All had received coronary artery bypass graft surgery from 2003 to 2006. They found that 30 percent of variation in transfusion practices seemed to be due to widely varied practices among hospital sites.

Also, blood use among women patients ranged from 72.5 percent to 100 percent, and blood use among men varied from about 50 percent to 100 percent. Transfusions with donor blood were associated with infections of the genitourinary system, respiratory tract, bloodstream, digestive tract and skin, the study said.

The risk of death in the hospital was nearly 5 times greater among patients who received a blood transfusion, and the risk of death in the next 30 days was nearly three times greater. Some of the risk may've been due to the underlying condition that led to transfusion but an increasingly convincing body of evidence demonstrates that some of the effect is almost certainly due to the transfusion itself, Blumberg said.

Blood transfusions are extremely common in the United States. Some of the typical reasons for transfusions include prevention of anemia and improving oxygen delivery in heart failure.

Blumberg has been a long-time advocate for fewer transfusions and, when they are necessary, for using blood from which the donor's white cells have been removed. This process, called leukoreduction, is believed to diminish the chances of infection and inflammation, research has shown.

"Blood transfusions are certainly necessary in life-threatening situations," Blumberg said. "But this study and other studies confirm they should be a last resort, not a first resort, as they often are."

For decades the URMC has been a leader in the study of blood transfusions, and Strong Memorial Hospital at URMC was among the first in the country to begin using leukoreduced blood for all its patients.

More recently, a team at Strong began to further refine the guidelines for blood transfusion. As a result the hospital has already seen a 10 to 15 percent drop in transfusions during the past six months. The improvement program is still in its early stages, and Blumberg said they will closely monitor the use of transfusions at Strong in the coming months.

Karin Christensen | EurekAlert!
Further information:

More articles from Studies and Analyses:

nachricht Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University

nachricht New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Researchers at Fraunhofer monitor re-entry of Chinese space station Tiangong-1

In just a few weeks from now, the Chinese space station Tiangong-1 will re-enter the Earth's atmosphere where it will to a large extent burn up. It is possible that some debris will reach the Earth's surface. Tiangong-1 is orbiting the Earth uncontrolled at a speed of approx. 29,000 km/h.Currently the prognosis relating to the time of impact currently lies within a window of several days. The scientists at Fraunhofer FHR have already been monitoring Tiangong-1 for a number of weeks with their TIRA system, one of the most powerful space observation radars in the world, with a view to supporting the German Space Situational Awareness Center and the ESA with their re-entry forecasts.

Following the loss of radio contact with Tiangong-1 in 2016 and due to the low orbital height, it is now inevitable that the Chinese space station will...

Im Focus: Alliance „OLED Licht Forum“ – Key partner for OLED lighting solutions

Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, provider of research and development services for OLED lighting solutions, announces the founding of the “OLED Licht Forum” and presents latest OLED design and lighting solutions during light+building, from March 18th – 23rd, 2018 in Frankfurt a.M./Germany, at booth no. F91 in Hall 4.0.

They are united in their passion for OLED (organic light emitting diodes) lighting with all of its unique facets and application possibilities. Thus experts in...

Im Focus: Mars' oceans formed early, possibly aided by massive volcanic eruptions

Oceans formed before Tharsis and evolved together, shaping climate history of Mars

A new scenario seeking to explain how Mars' putative oceans came and went over the last 4 billion years implies that the oceans formed several hundred million...

Im Focus: Tiny implants for cells are functional in vivo

For the first time, an interdisciplinary team from the University of Basel has succeeded in integrating artificial organelles into the cells of live zebrafish embryos. This innovative approach using artificial organelles as cellular implants offers new potential in treating a range of diseases, as the authors report in an article published in Nature Communications.

In the cells of higher organisms, organelles such as the nucleus or mitochondria perform a range of complex functions necessary for life. In the networks of...

Im Focus: Locomotion control with photopigments

Researchers from Göttingen University discover additional function of opsins

Animal photoreceptors capture light with photopigments. Researchers from the University of Göttingen have now discovered that these photopigments fulfill an...

All Focus news of the innovation-report >>>



Industry & Economy
Event News

Virtual reality conference comes to Reutlingen

19.03.2018 | Event News

Ultrafast Wireless and Chip Design at the DATE Conference in Dresden

16.03.2018 | Event News

International Tinnitus Conference of the Tinnitus Research Initiative in Regensburg

13.03.2018 | Event News

Latest News

TRAPPIST-1 planets provide clues to the nature of habitable worlds

21.03.2018 | Physics and Astronomy

The search for dark matter widens

21.03.2018 | Materials Sciences

Natural enemies reduce pesticide use

21.03.2018 | Life Sciences

Science & Research
Overview of more VideoLinks >>>