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Blood transfusion in cardiac surgery
1Department of Surgery, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. rthurer@caregroup.harvard.edu
Summary
Transfusion practices in cardiac surgery vary significantly despite blood conservation efforts. Continued research is needed to minimize transfusions due to risks and costs.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Transfusion Medicine
Background:
- Cardiothoracic surgeons and anesthesiologists have long focused on appropriate transfusion therapy.
- Cardiac surgery patients face risks from both bleeding and transfusions.
Purpose of the Study:
- To review transfusion practices, risks, and new technologies in cardiac surgery.
- To highlight variations in transfusion patterns and their implications.
Main Methods:
- Literature review on transfusion variability, risks (infectious and non-infectious), and technology impact.
- Presentation of data from a specific cardiac surgery registry.
Main Results:
- Blood conservation strategies (salvage, hemodilution, drugs) exist but practices vary widely.
- Transfusion-transmitted disease risks are reduced, but overall transfusion rates are increasing.
- Non-infectious transfusion hazards remain significant; newer surgical techniques may reduce blood use.
Conclusions:
- Minimizing transfusions in cardiac surgery is crucial due to cost, availability, and potential harm.
- Ongoing research and development of methods to reduce transfusion necessity are vital.