Table 1 Details of included studies
Study | Number of patients | Cardiac surgery type | Total prime volume (mL) | Albumin group | Artificial Colloid group | Crystalloid group | Additional priming solutions | Intraoperative RBC transfusion (units) | Postoperative RBC transfusion (the 1st 24Â h; units) | Total perioperative red blood cells transfusions (until 1st 24Â h after surgery; units) | Postoperative blood loss or chest tube drainage | RBC transfusion thresholds |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Ohqvist 1981 [1] | 14 | Valve | 2000 | 20% albumin 200 ml + Ringers 1800 ml | - | Ringers 2000 ml | - | - | - | - | ✔ | - |
Marelli 1989 [2] | 100 | CABG; Valve | - | Additional 200 ml 25% albumin | - | Ringers | - | ✔ | - | - | - | - |
Kuitunen 1993 [3] | 30 | CABG | 2000 | - | HES 6% 20 ml/kg + Ringers | Ringers 2000 ml | - | ✔ | - | - | - | During CPB: Hct > 20%; Postoperative criteria: Hct > 30%. |
Scott 1995 [4] | 93 | CABG | 2000 (1600 for patients < 60 kg) | 4.6% albumin 1000 ml + Plasmalyte 1000 ml | Polygeline 1000 ml + Plasmalyte 1000 ml | Plasmalyte 2000 ml | - | - | - | - | Blood loss | During CPB: Hct > 18%; Postoperative criteria: not applied. |
Tamayo 2008 [5] | 44 | CABG | 1750 | - | Gelatin 1000 ml + Ringers 500 ml | Ringers 1500 ml | 20% mannitol 100 ml; aprotinin 100 ml; 8.4% sodium bicarbonate 50 ml; heparin 5000IU | - | - | - | Blood loss | During CPB: Hct was maintained at 20–25%; Postoperative criteria: not applied. |
Cho 2014 [6] | 36 | CABG; Valve; Aortic | - | 5% albumin 500 ml + Plasmalyte 1000 ml | 6% HES 130/0.4 500 ml + Plasmalyte 1000 ml (max 20 ml/kg.day HES) | - | 20% mannitol 5mL/kg; sodium bicarbonate 40mEq; heparin 10 mg/L | ✔ | ✔ | - | Blood loss | During CPB: Hct > 20%; Postoperative criteria: Hct > 25%. |
Skhirtladze 2014 [7] | 236 | CABG; Valve; Aortic | 1500 | 5% albumin (max 50 ml/kg.day) + Ringers | 6% HES 130/0.4 (max 50 ml/kg.day) + Ringers | Ringers 1500 ml | 20% mannitol 100 ml; heparin 5000 IU | ✔ | ✔ | ✔ | Chest tube drainage | During CPB: Hb > 7 g/dL; Postoperative criteria: Hb > 8-9 g/dL. |
Yanartas 2015 [8] | 132 | CABG | 1500 | - | 6% HES 130/0.4 10 ml/kg + Ringers 10 ml/kg | Ringers 20 ml/kg | 20% mannitol 0.5 g/kg; 7.5% sodium bicarbonate 1 ml/kg; heparin 150IU/kg | ✔ | ✔ | - | Chest tube drainage | During CPB: Hct was maintained at 22–28%; Postoperative criteria: Hct was maintained at 30%. |
Maleki 2016 [9] | 60 | CABG | 1500 | 5% albumin 500 ml + 0.9% NaCl 1000 ml | 6% HES 130/0.4 500 ml + 0.9% NaCl 1000 ml | - | 20% Mannitol 5mL/kg; sodium bicarbonate 45mEq; heparin 10 mg/L | - | - | ✔ | Blood loss | During CPB: Hb > 7 g/dL; Postoperative criteria: Hct > 21%. |
Talvasto 2023 [10] | 1386 | CABG; Valve; Aortic | 1500 | 20% albumin 300 ml + 1200 ml Ringers | - | Ringers 1500 ml | - | ✔ | ✔ | ✔ | - | Based on clinical judgement |