Randomized Trial of a Liberal Versus a Restrictive Transfusion Strategy in Elderly Cardiac Surgery Patients

Evaluation of a Liberal Versus Restrictive Blood Transfusion Strategy in Elderly Patients Following Coronary Bypass or Aortic Valve Surgery

The purpose of this study is to determine whether a less restrictive strategy of red blood cell transfusion in elderly patients following coronary bypass surgery results in enhanced postoperative recovery as determined by quality of life assessment, exercise tolerance and clinical outcomes.

Two postoperative transfusion strategies:

1. Liberal - transfused when Hgb is <100g/L
2. Restrictive - transfused when Hgb is <70g/L

Inclusion Criteria:

• Patients >=70 years of age undergoing non-emergency coronary artery bypass surgery
• Initial postoperative hemoglobin level 70-90g/L

Exclusion Criteria:

• Patients who are unable to provide informed consent in English
• Patients with preoperative hemoglobin concentrations <100g/L
• Patients who require emergency re-operation
• Patients with intraoperative or postoperative bleeding diathesis
• Patients with postoperative clinical instability (eg. low output state)
• Patients in whom insertion of an intra-aortic balloon pump is required