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Major Bleeding, Transfusions, and Anemia: The Deadly Triad of Cardiac Surgery
Dr Ranucci and collegues have analysed data collected about bleeding and transfusion in over 16,000 patients over a 12 year period. Where major bleeding (>900 ml in 12 hrs) occurred, mortality was increased. Other factors associated with mortality included red cell transfusion and preoperative anemia. This is further evidence of the harmful effects of bleeding and its consequences. It supports close attention being paid to factors that can reduce bleeding - stopping drugs associated with bleeding, and use of protocols to determine and manage excessive blood loss and reduce exposure to blood products.