Mirhosseini Seyed Jalil, Zadeh Mehdi Haddad, Ali-Hassan-Sayegh Sadegh, Dehnavi Naime Dehghan
Department of Cardiovascular Surgery, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Asian J Transfus Sci. 2013 Jan;7(1):51-4. doi: 10.4103/0973-6247.106737.
Neurological disorders are common complications following coronary artery bypass graft (CABG). Dizziness in convalescence period is of high importance because it can prolong patient's stay at the hospital and decrease in sense of rehealing. Transfusion indication is seen in hemoglobin levels <7 g/dl; however, dizziness has been frequently observed in patients with hemoglobin levels 7-10 g/dl and they have dramatic response to transfusion. Therefore, this study was designed to evaluate effect of transfusion on dizziness in hemoglobin levels of 7-10 g/dl to set a more accurate indication for transfusion in anemic patients after elective off-pump CABG.
This clinical trial study was conducted on 90 patients undergoing elective off-pump CABG surgery from January to June 2011, in Afshar cardiovascular center, Yazd, Iran. Patients with hemoglobin levels of 7-10 g/ dl measured 48 h after CABG were included in this study and those who stayed in ICU more than 48 h were excluded. The subjects were randomly divided into two groups: the experimental group received packed cell according to study protocol while the control group did not receive packed cell. Hemoglobin concentration was measured at 48 h and 72 h after CABG and discharge time, respectively. Dizziness was evaluated 72 h after surgery. Data were analyzed by ANOVA, Chi-square, and Fisher's exact test for quantitative and qualitative variables.
The mean age of the patients was 63.5 ± 10.67 years, from all of patients in which 50 cases (55.6%) were males and 40 cases (44.4%) were females. Dizziness after surgery occurred in 35 cases (38.8%), of whom, 27 cases (62.8%) were in the control group and 8 cases (17%) were in the transfusion group. Significantly a difference in the incidence of dizziness was found between two groups (P= 0.001).
Transfusion in hemoglobin levels of 7-10 g/dl can be useful to decrease dizziness in anemic patients after elective off-pump CABG; however, the guidelines in textbooks suggest transfusion after CABG to be in hemoglobin levels <7 g/dl.
神经系统疾病是冠状动脉旁路移植术（CABG）后常见的并发症。恢复期头晕非常重要，因为它会延长患者住院时间并降低康复感。输血指征为血红蛋白水平<7g/dl；然而，血红蛋白水平为7-10g/dl的患者经常出现头晕，且他们对输血有显著反应。因此，本研究旨在评估输血对血红蛋白水平为7-10g/dl的头晕患者的影响，以便为择期非体外循环冠状动脉搭桥术后贫血患者设定更准确的输血指征。
本临床试验研究于2011年1月至6月在伊朗亚兹德的阿夫沙尔心血管中心对90例行择期非体外循环冠状动脉搭桥术的患者进行。纳入冠状动脉搭桥术后48小时血红蛋白水平为7-10g/dl的患者，排除在重症监护病房停留超过48小时的患者。将受试者随机分为两组：试验组根据研究方案接受红细胞悬液，对照组不接受红细胞悬液。分别在冠状动脉搭桥术后48小时、72小时及出院时测量血红蛋白浓度。术后72小时评估头晕情况。采用方差分析、卡方检验和Fisher精确检验对定量和定性变量进行数据分析。
患者的平均年龄为63.5±10.67岁，其中50例（55.6%）为男性，40例（44.4%）为女性。术后头晕发生35例（38.8%），其中27例（62.8%）在对照组，8例（17%）在输血组。两组头晕发生率有显著差异（P=0.001）。
血红蛋白水平为7-10g/dl时输血有助于减少择期非体外循环冠状动脉搭桥术后贫血患者的头晕；然而，教科书中的指南建议冠状动脉搭桥术后血红蛋白水平<7g/dl时输血。
