Influence of a blood component program on postoperative complication rates: a retrospective study in 372 patients

We did a retrospective study of 372 thoracic and cardiovascular surgery patients, except open heart cases, which were treated by the same senior staff during the last year before (N = 197) and the first year after (N = 175) the introduction of a blood component program. There were no other basic changes of therapeutic policies. The two populations were comparable with respect to various basic characteristics. During the period 'before' the large majority of red cell units was 'deplasmatized' blood with a plasma deficit of 100 ml and a hematocrit of 40%. During the period 'after' it was red cell concentrates with a plasma deficit of 200 ml and a hematocrit of 70%. The usage pattern of red cell units did not change. The only statistically significant (and deliberate) quantitative difference between the transfusion regimens 'before' and 'after' was a more extensive intraoperative use of a gelatin plasma substitute to balance the plasma deficit of the red cell concentrates. As judged by various criteria, the postoperative courses of the patients 'before' and 'after' were virtually indistinguishable. We conclude that the blood component program practised at our hospital has no adverse effects on the postoperative course.