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Difficult Decisions in Cardiothoracic Critical Care Surgery pp 445–453Cite as

Bleeding in Cardiac Surgery: Should Massive Transfusion Be in a 1:1:1 Ratio?

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Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

Abstract

Nearly 10% of postoperative cardiothoracic surgery patients will require transfusion of at least five units of packed red blood cells. This transfusion requirement is multifactorial, however cardiothoracic patients should be considered higher risk for hemorrhage. The optimal transfusion ratio for post cardiac surgery hemorrhage is unclear. Conversely, for trauma patients, the effect of transfusion ratios on outcomes has been studied extensively. For these patients, a balanced transfusion ratio of 1:1:1 (plasma, platelets, red blood cells) results in a decrease in bleeding specific mortality.

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Authors and Affiliations

  1. Division of Trauma and Acute Care Surgery, Los Angeles County and University of Southern California Medical Center, Los Angeles, CA, USA

    James M. Bardes & Kenji Inaba

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  1. James M. Bardes
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  2. Kenji Inaba
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Correspondence to Kenji Inaba .

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Editors and Affiliations

  1. University of Chicago Medicine, Chicago, IL, USA

    Vassyl A. Lonchyna

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Bardes, J.M., Inaba, K. (2019). Bleeding in Cardiac Surgery: Should Massive Transfusion Be in a 1:1:1 Ratio?. In: Lonchyna, V. (eds) Difficult Decisions in Cardiothoracic Critical Care Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-04146-5_31

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  • DOI: https://doi.org/10.1007/978-3-030-04146-5_31

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-04145-8

  • Online ISBN: 978-3-030-04146-5

  • eBook Packages: MedicineMedicine (R0)

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