6/30/23, 2:19 AM TRACS Pathway Feedback Search Clinical Topics Home Studies TRACS TRACS Disease Disease Disease Aortic regurgitation Aortic stenosis Mitral regu Trial question Is restrictive perioperative transfusion strategy noninferior to liberal transfusion strategy in patients undergoing cardiac surgery? Study design Single center Single blinded RCT Population Characteristics of study participants 38.0% female N = 502 62.0% male 502 patients (192 female, 310 male) Inclusion criteria: adult patients undergoing elective cardiac surgery with cardiopulmonary bypass Key exclusion criteria: emergency procedure; LV aneurysm resection; inability to receive blood products; chronic anemia; low platelet count; hepatic dysfunction; end-stage renal disease Interventions N=249 a restrictive strategy (blood transfusion when hematocrit < 24%) N=253 a liberal strategy (blood transfusion when hematocrit < 30%) Primary outcome Death from all causes and severe morbidity during hospital stay https://web.pathway.md/studies/reccOHItnzERyzgCZ 1/2 6/30/23, 2:19 AM TRACS Pathway 11.0 % 11 10 8.3 % 5.5 % Difference not exceeding nonferiority margin 2.8 % 0.0 % A restrictive strategy A liberal strategy Difference not exceeding nonferiority margin in death from all causes and severe morbidity during the hospital stay (11% vs. 10%; AD 1%, 95% CI -6 to 4) Secondary outcomes No significant difference in death at day 30 (6% vs. 5%; AD 1%, 95% CI -19.45 to 21.45) No significant difference in cardiac complications (24% vs. 21%; AD 3%, 95% CI -2.3 to 8.3) Conclusion In adult patients undergoing elective cardiac surgery with cardiopulmonary bypass, a restrictive strategy was noninferior to a liberal strategy with respect to death from all causes and severe morbidity during the hospital stay. Reference Ludhmila A Hajjar, Jean-Louis Vincent, Filomena R B G Galas et al. Transfusion requirements after cardiac surgery: the TRACS randomized controlled trial. JAMA. 2010 Oct 13;304(14):1559-67. Open reference URL https://web.pathway.md/studies/reccOHItnzERyzgCZ 2/2