General Critical Care

A systematic review and meta-analysis were undertaken to assess the implications of perioperative red blood cell transfusion on postoperative outcomes following elective major abdominal surgery. Publications from January 1, 2000, to June 6, 2020, in the PubMed, Cochrane, and Scopus databases were meticulously evaluated. Although no randomized controlled trials emerged, out of the 39 observational studies identified, 37 were integrated into the meta-analysis.

The analysis unequivocally establishes that perioperative blood transfusions are correlated with elevated risks of negative postoperative outcomes for elective major abdominal surgeries, spanning both the short and long term. This revelation accentuates the imperative of adopting patient blood management measures, with the end goal being optimizing the use of a patient's own blood and diminishing the reliance on transfusions.

Outcomes following perioperative red blood cell transfusion in patients undergoing elective major abdominal surgery: a systematic review and meta-analysis - British Journal of Anaesthesia (bjanaesthesia.org)

Goal-directed Perioperative Albumin Substitution Versus Standard of Care to Reduce Postoperative Complications - A Randomized Clinical Trial (SuperAdd Trial)

In this single-center, randomized, controlled clinical trial, researchers investigated the effectiveness of goal-directed albumin substitution in reducing postoperative complications in adult patients with hypoalbuminemia undergoing high-risk surgery. The primary objective was to maintain serum albumin concentration above 30 g/L perioperatively and evaluate its impact on postoperative complications using the Clavien-Dindo Classification (CDC). The trial included 2509 patients, of which 600 (23.9%) developed serum albumin concentrations below 30 g/L. Among them, 299 patients (99.7%) received human albumin in the intervention group, while only 54 patients (18.0%) received it in the standard care group. The results showed that at least one postoperative complication classified as CDC≥2 occurred in 84.7% of patients in the intervention group and 87.3% in the standard treatment group, with a risk difference of -2.7% (95% CI, -8.3% to 2.9%).…