PBM as Strategy to CABG Anemic Patients Bypass Graft (CABG)
120 patients around the world
Available in Brazil
Anemia increases the risk of postoperative complications and mortality in patients
undergoing coronary artery bypass grafting (CABG). In addition, the use of blood
transfusions during cardiac surgery is associated with adverse effects and unfavorable
outcomes. To reduce the need for transfusions and improve post-operative results,
erythropoietin is used as part of Patient Blood Management (PBM). In anemic patients
undergoing CABG, the use of Erythropoietin (EPO) can eliminate the need for blood
components during and after surgery, as well as reduce adverse events and inflammation.
The objectives of the proposed study are to reduce or eliminate the number of
transfusions in the intraoperative and postoperative context by means of a Patient Blood
Management (PBM) anemia treatment protocol for anemic patients who will undergo Coronary
Artery Bypass Graft Surgery (CABG). The proposed study is a prospective, non-controlled
interventional study to be carried out with anemic patients awaiting CABG surgery at
Hospital São Paulo. There will be three groups of 40 participants each: Control Group
(CG) of non-anemic individuals preoperatively; Non- PBM Group (NPBMG) of anemic
individuals preoperatively and treated with blood components according to need; PBM Group
(GPBM) of anemic individuals preoperatively and treated with EPO. The following
parameters will be compared: length of postoperative hospital stay; mortality;
postoperative cardiovascular events: clinical stroke, perioperative infarction, surgical
reoperation due to bleeding; non- cardiovascular events: surgical site-associated
infection and acute renal dysfunction; time in postoperative intensive care; time on
mechanical ventilation; need for vasoactive drug use; inflammatory process and intra- and
postoperative cardiac cell death. Confounding factors such as demographic and clinical
parameters will be included in the analysis. It is expected that the GPBM will obtain the
best results in relation to the GNPBM, similar to or better than the CG.