Abstract
Objectives Atrial fibrillation (AF) is the most common complication after coronary artery bypass
grafting (CABG). It is associated with prolonged hospital stay and increased cost.
The aim of this study is to investigate the relationship between transfusion of blood
derivatives and occurrence of postoperative paroxysmal AF.
Materials and Methods From June 2012 to February 2014, 446 patients undergoing CABG with cardiopulmonary
bypass (CPB) were prospectively evaluated for occurrence of postoperative AF. Patients
and procedural variables were recorded and were associated with the development of
new-onset AF with logistic regression analysis.
Results AF developed in 111 patients (24.9%). Preoperative factors associated with the development
of new-onset AF included age (p < 0.05), higher EuroSCORE II (p < 0.05), carotid disease (p = 0.01), peripheral vascular disease (p = 0.02), chronic obstructive pulmonary disease (p = 0.03), renal failure (p = 0.05), and cardiac failure (p = 0.01). Intraoperative and postoperative parameters included duration of CPB (p < 0.05), number of grafts (p = 0.009), intubation time (p = 0.001), occurrence of postoperative stroke (p = 0.01), transient ischemic attack (p = 0.02), need for prolonged ventilation (p = 0.002), development of respiratory tract infection (p = 0.02), need for noninvasive ventilation (p = 0.001), reintubation (p = 0.02), development of postoperative acute kidney injury (p = 0.002), and postoperative neurocognitive dysfunction (p = 0.002). The number of red blood cell (RBC) units transfused during surgery (p = 0.7) and the total number of RBC units transfused (p = 0.2) as well as units of fresh frozen plasma (p = 0. 7) and platelets units transfused in total (p = 0.3) were not found to increase the risk of postoperative AF.
Conclusion Intraoperative and postoperative blood products transfusion in patients operated
for CABG is not associated with increased risk of developing postoperative AF.
Keywords
postoperative paroxysmal atrial fibrillation - transfusion - red blood cells - fresh
frozen plasma - CABG
