{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T02:38:00Z","timestamp":1775183880020,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T00:00:00Z","timestamp":1607299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>During vascular surgery, restricted red\u2010cell transfusion reduces frontal lobe oxygen (ScO<jats:sub>2<\/jats:sub>) saturation as determined by near\u2010infrared spectroscopy. We evaluated whether inadequate increase in cardiac output (CO) following haemodilution explains reduction in ScO<jats:sub>2<\/jats:sub>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a post\u2010hoc analysis of data from the Transfusion in Vascular surgery (TV) Trial where patients were randomized on haemoglobin drop below 9.7\u00a0g\/dL to red\u2010cell transfusion at haemoglobin below 8.0 (low\u2010trigger) vs 9.7\u00a0g\/dL (high\u2010trigger). Fluid administration was guided by optimizing stroke volume. We compared mean intraoperative levels of CO, haemoglobin, oxygen delivery, and CO at nadir ScO<jats:sub>2<\/jats:sub> with linear regression adjusted for age, operation type and baseline. Data for 46 patients randomized before end of surgery were included for analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The low\u2010trigger resulted in a 7.1% lower mean intraoperative haemoglobin level (mean difference, \u22120.74\u00a0g\/dL; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and reduced volume of red\u2010cell transfused (median [inter\u2010quartile range], 0 [0\u2010300] vs 450\u00a0mL [300\u2010675]; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) compared with the high\u2010trigger group. Mean CO during surgery was numerically 7.3% higher in the low\u2010trigger compared with the high\u2010trigger group (mean difference, 0.36 L\/min; 95% confidence interval (CI.95), \u22120.05 to 0.78; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.092; n\u00a0=\u00a042). At the nadir ScO<jats:sub>2<\/jats:sub>\u2010level, CO was 11.9% higher in the low\u2010trigger group (mean difference, 0.58 L\/min; CI.95, 0.10\u20101.07; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.024). No difference in oxygen delivery was detected between trial groups (MD, 1.39 dL<jats:sub>O2<\/jats:sub>\/min; CI.95, \u22126.16 to 8.93; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.721).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Vascular surgical patients exposed to restrictive RBC transfusion elicit the expected increase in CO making it unlikely that their potentially limited cardiac capacity explains the associated ScO<jats:sub>2<\/jats:sub> decrease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13733","type":"journal-article","created":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T19:36:00Z","timestamp":1604432160000},"page":"302-312","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of low vs high haemoglobin transfusion trigger on cardiac output in patients undergoing elective vascular surgery: Post\u2010hoc analysis of a randomized trial"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1288-6326","authenticated-orcid":false,"given":"Anders","family":"M\u00f8ller","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive care N\u00e6stved\u2010Slagelse\u2010Ringsted Slagelse Hospital Slagelse Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7778-1771","authenticated-orcid":false,"given":"J\u00f8rn","family":"Wetterslev","sequence":"additional","affiliation":[{"name":"Copenhagen Trial Unit Centre for Clinical Intervention Research, Rigshospitalet Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeid","family":"Shahidi","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Surgery Zealand University Hospital Roskilde Roskilde Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorthe","family":"Hellemann","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive care N\u00e6stved\u2010Slagelse\u2010Ringsted Slagelse Hospital Slagelse Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niels H.","family":"Secher","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Rigshospitalet University of Copenhagen Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ole B.","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology N\u00e6stved Hospital Nastved Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus V.","family":"Marcussen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive care N\u00e6stved\u2010Slagelse\u2010Ringsted Slagelse Hospital Slagelse Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedicte G. 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