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Related Concept Videos

Hemoglobin01:24

Hemoglobin

Hemoglobin is a globular protein made up of four subunits. Two of these subunits are alpha chains, and the other two are beta chains. Each subunit contains a molecule of heme, which has an iron atom and can bind to oxygen. When an oxygen molecule binds to one heme group, it changes the shape of hemoglobin, making it easier for the other heme groups to bind oxygen as well.
When all four heme groups are bound to oxygen, the resulting molecule is called oxyhemoglobin. As a result, arterial blood...
Oxygen Transport in the Blood01:27

Oxygen Transport in the Blood

Hemoglobin (Hb) is a crucial molecule in the human body, consisting of four polypeptide chains, each bound to an iron-containing heme group. This unique structure enables hemoglobin to bind to oxygen, with each molecule capable of combining with four molecules of oxygen, leading to rapid and reversible oxygen loading. When fully loaded with oxygen, it is called oxyhemoglobin, while hemoglobin that has released oxygen is called reduced hemoglobin or deoxyhemoglobin. As hemoglobin binds oxygen,...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Respiration and Gaseous Exchange01:20

Respiration and Gaseous Exchange

The intricate interplay between the cardiovascular and respiratory systems is crucial for efficiently transporting respiratory gases throughout the body. Let us explore the cardiovascular system's multifaceted functions, emphasizing its pivotal role in gas exchange.
Respiration involves the exchange of gases, especially oxygen (O2) and carbon dioxide (CO2), between the alveoli and body cells, a process facilitated by blood circulation. As a result, the cardiovascular system, which involves the...
Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

Blood Studies for Cardiovascular System I: Cardiac Biomarkers

Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
Factors Affecting Erythropoiesis01:24

Factors Affecting Erythropoiesis

The cardiovascular system regulates the number of erythrocytes in the bloodstream to ensure optimal oxygen transport. It also prevents over-proliferation of these cells, which helps to maintain blood viscosity and flow rate.
Several factors influence the erythrocyte production rate, with tissue oxygen level being among the most critical. Intense exercise or high altitudes can cause tissue hypoxia, which triggers the kidneys to release more erythropoietin (EPO) into the bloodstream.
EPO then...

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Updated: May 22, 2026

Implantation of the Syncardia Total Artificial Heart
16:11

Implantation of the Syncardia Total Artificial Heart

Published on: July 18, 2014

Hemoglobin drift after cardiac surgery.

Timothy J George1, Claude A Beaty, Arman Kilic

  • 1Division of Cardiac Surgery, Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.

The Annals of Thoracic Surgery
|May 22, 2012
PubMed
Summary
This summary is machine-generated.

Postoperative cardiac surgery patients experience hemoglobin drift, but most show recovery by discharge. This suggests caution before administering red blood cell transfusions.

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Published on: November 5, 2019

Area of Science:

  • Cardiology
  • Transfusion Medicine
  • Critical Care Medicine

Background:

  • Restrictive red blood cell transfusion strategies are linked to better outcomes in cardiac surgery.
  • Postoperative fluid shifts can cause hemoglobin levels to decrease, complicating transfusion decisions.
  • Understanding hemoglobin level progression is crucial for optimizing patient care.

Purpose of the Study:

  • To define the natural progression of hemoglobin levels in patients following cardiac surgery.
  • To analyze hemoglobin drift patterns in relation to transfusion status and clinical factors.

Main Methods:

  • Retrospective analysis of 199 cardiac surgery patients who did not receive postoperative transfusions.
  • Stratification based on intraoperative transfusion status.
  • Evaluation of hemoglobin change relative to initial postoperative levels, including maximal and final drift.

Main Results:

  • Hemoglobin levels decreased postoperatively, with an average final drift of 1.1 g/dL.
  • Maximal hemoglobin drift was 1.8 g/dL and unaffected by intraoperative transfusion.
  • Despite initial drops, 79% of patients showed hemoglobin recovery by discharge, averaging 0.7 g/dL.

Conclusions:

  • All postoperative cardiac surgery patients experience some hemoglobin drift.
  • A significant majority of patients demonstrate hemoglobin recovery before discharge.
  • Physicians should consider this natural hemoglobin recovery trend prior to transfusing red blood cells.