Multi-modality blood conservation strategy in open-heart surgery: an audit

Area of Science:

• Cardiovascular Surgery
• Transfusion Medicine
• Patient Blood Management

Background:

• Open-heart surgery often involves significant blood loss, leading to the use of homologous blood and blood products.
• Patient blood management protocols aim to minimize transfusions, reduce risks, and control costs in surgical settings.

Purpose of the Study:

• To audit the utilization of homologous blood and blood products in open-heart surgery patients.
• To evaluate the effectiveness of an in-house blood conservation protocol implemented by a single surgical team.

Main Methods:

• Retrospective review of hospital records for 310 consecutive adult patients undergoing open-heart surgery.
• Analysis of homologous blood and blood product usage during and after surgery, including intensive care unit stay and up to hospital discharge.

Main Results:

• A significant majority of patients (82.6%) did not receive any blood or blood products.
• Only 17.4% of patients required one or more units of allogeneic transfusion.
• Mean hemoglobin at discharge was 9.8 g/dL, indicating adequate levels post-intervention.

Conclusions:

• A standardized, multidisciplinary blood conservation approach in cardiac surgery is effective.
• This protocol leads to decreased bleeding and transfusion requirements safely and cost-effectively.