Ultrafiltration is thought to reduce morbidity and the risk of red blood cell transfusion, however very few studies have examined the relationship between ultrafiltration and the overall risk of intraoperative RBC transfusion. Using data from the SpecialtyCare Operative Procedural Registry (SCOPE™), our study looks at a population of nearly 98,000 adults undergoing cardiac surgery at 197 hospitals to evaluate the effects of ultrafiltration volume removed during CPB on the relative risk of receiving an intraoperative RBC transfusion. Recognizing the findings of our own previous work, we were especially interested in testing potential differences between male and female patients in the effects of ultrafiltration.
It is a fairly well-known fact in the cardiac community that women have higher morbidity and mortality associated with coronary artery bypass (CABG) procedures. The reasons traditionally given for this disparity include women’s relatively smaller vasculature, higher incidence of anemia, and smaller circulating blood volume. Early in 2016, we in the Medical Department were discussing this phenomenon and decided to design a study using the robust data from our SpecialtyCare Operative Procedural Registry to find something in the intraoperative space that might be leading to these very different post-operative outcomes for men and women. Our findings were somewhat surprising.