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Programmatic blood conservation in cardiac surgery
1Perioperative Blood Conservation Program, London Health Sciences Centre, London, Canada. fralley@uwo.ca
Insights
Cardiac surgery uses significant blood resources, prompting advances in blood conservation. An organized approach to cardiac surgery blood conservation effectively reduces perioperative allogeneic blood use.
Area of Science:
- Cardiovascular Surgery
- Transfusion Medicine
Background:
- Cardiac surgery accounts for 10-20% of US blood transfusions, straining the national supply.
- This demand has driven innovation in blood conservation strategies.
Purpose of the Study:
- To describe current blood conservation modalities used in cardiac surgery.
- To highlight the effectiveness of organized approaches in reducing perioperative blood product use.
Main Methods:
- Review of various technical and pharmacological blood conservation techniques.
- Emphasis on preoperative planning and coordinated perioperative strategies.
Main Results:
- Organized blood conservation significantly reduces perioperative allogeneic blood and blood product use.
- Blood conservation techniques are diverse, varied, and may be costly, limiting uniform application.
Conclusions:
- A coordinated perioperative plan is essential for effective blood conservation in cardiac surgery.
- Appropriate application of blood conservation modalities ensures benefits throughout the perioperative period.
Abstract:
Despite efforts to reduce blood transfusion rates in cardiac surgery over the past 40 years, cardiac surgery still consumes 10% to 20% of the blood transfused in the United States. This large demand has not only placed a significant pressure on the national blood supply, resulting in frequent shortages, but also has lead to many technical and pharmacological advances in blood conservation strategies in recent years. Recently, studies have shown that an organized approach to blood conservation in cardiac surgery is effective in significantly reducing the perioperative use of allogeneic blood and blood products. However, blood conservation techniques are multiple, varied, and in many situations costly and thus cannot be uniformly applied to all patients. Early preoperative planning and a coordinated perioperative plan allow the appropriate use of blood conservation modalities to ensure that their benefits span the entire perioperative period. This article describes some of the modalities currently used in patients undergoing cardiac surgery.
