ReviewBritish journal of anaesthesia2021
Patient blood management interventions do not lead to important clinical benefits or cost-effectiveness for major surgery: a network meta-analysis.
Review in British journal of anaesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06358079 (Isolated Cardiotomy Circuit for Re-infusion of Unwashed Shed Blood During Off-pump Coronary Artery Surgery), which is not on this map. Cited by 32 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Isolated Cardiotomy Circuit for Re-infusion of Unwashed Shed Blood During Off-pump Coronary Artery Surgery
Who cites it
32 citing papers in PubMed, 5 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- Restrictive versus Liberal Transfusion Strategies in Acute Myocardial Infarction and Anemia: A Meta-Analysis and Trial Sequential Analysis.Arquivos brasileiros de cardiologia · 2024Pooled it
- Intravenous Iron Therapy to Treat Anemia in Oncology: A Mapping Review of Randomized Controlled Trials.Current oncology (Toronto, Ont.) · 2023Pooled it
- Pooled it
- Transfusion thresholds for guiding red blood cell transfusion.The Cochrane database of systematic reviews · 2021Pooled it
- Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine.Intensive care medicine · 2021Guideline
- Effect of Tranexamic Acid on Postoperative Bleeding in Sleeve Gastrectomy: a Randomized Trial.Obesity surgery · 2023Trial
- Scaling up Quality Improvement for Surgical Teams (QIST)-avoiding surgical site infection and anaemia at the time of surgery: a cluster randomised controlled trial of the effectiveness of quality improvement collaboratives to introduce change in the NHS.Implementation science : IS · 2022Trial
- Survey on perioperative tranexamic acid use.British journal of haematology · 2026Article
- Multicenter external validation of the FW-TRIC score for predicting red blood cell transfusion in on-pump cardiac surgery.Perioperative medicine (London, England) · 2026Article
- Budget Impact of Preoperative Anemia Management, the First Pillar of Patient Blood Management, on the Romanian Healthcare System.Clinical drug investigation · 2026Article
- Anemia and Iron Deficiency in Cardiac Surgery Patients: Prevalence, Implications, and Therapeutic Considerations.Journal of clinical medicine · 2025Review
- Predictive accuracy of diagnostic tests for excessive bleeding in cardiac surgery: The COPTIC-C study.Transfusion · 2025Article
- Review
- Provision of peri-operative patient blood management strategies in the UK: a national survey of practice.Anaesthesia · 2025Article
- 2024 EACTS/EACTAIC Guidelines on patient blood management in adult cardiac surgery in collaboration with EBCP.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- 2024 EACTS/EACTAIC Guidelines on patient blood management in adult cardiac surgery in collaboration with EBCP.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025Article
- Article
- PBM and ERAS: mandatory bedfellows.Blood transfusion = Trasfusione del sangue · 2025Article
- Recommendations for diagnosis, treatment, and prevention of iron deficiency and iron deficiency anemia.HemaSphere · 2024Article
- Inhaled NO at a crossroads in cardiac surgery: current need to improve mechanistic understanding, clinical trial design and scientific evidence.Frontiers in cardiovascular medicine · 2024Review
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Authors and funding
13 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundPatient blood management (PBM) interventions aim to improve clinical outcomes by reducing bleeding and transfusion. We assessed whether existing evidence supports the routine use of combinations of these interventions during and after major surgery.
methodsFive systematic reviews and a National Institute of Health and Care Excellence health economic review of trials of common PBM interventions enrolling participants of any age undergoing surgery were updated. The last search was on June 1, 2019. Studies in trauma, burns, gastrointestinal haemorrhage, gynaecology, dentistry, or critical care were excluded. The co-primary outcomes were: risk of receiving red cell transfusion and 30-day or hospital all-cause mortality. Treatment effects were estimated using random-effects models and risk ratios (RR) with 95% confidence intervals (CIs). Heterogeneity assessments used I
resultsSearches identified 393 eligible randomised controlled trials enrolling 54 917 participants. PBM interventions resulted in a reduction in exposure to red cell transfusion (RR=0.60; 95% CI 0.57, 0.63; I
conclusionsIn randomised trials, PBM interventions do not have important clinical benefits beyond reducing bleeding and transfusion in people undergoing major surgery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.