The article “Association Between Adverse Clinical Outcomes After Coronary Artery Bypass Grafting and Perioperative Blood Transfusions” (2019;39[1]: 26-35) caught my attention. Having had to transfuse all types of blood products to this population, I always thought that transfusions were absolutely necessary to improve those patients’ health. I learned, instead, that perioperative red blood cell (RBC) transfusion could be a factor leading to increased postoperative mortality and morbidity. Although offering valuable information, this article is less than convincing that transfusion of RBCs alone is to be blamed for those patients’ poor clinical outcomes.

Coronary artery bypass graft (CABG) surgery is considered 1 of the most invasive types of surgical interventions. It involves both the peripheral blood vessels (donor sites) and the coronary arteries (receiver sites), placing the patient at higher risk for blood loss; hence the rationale for volume replacement during and after the procedure. However, not everyone requires blood products...

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