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[Effects of multidisciplinary blood management strategy on transfusion and outcomes in patients undergoing valvular

Hongwen Ji1, Zhiyuan Li1, Hansong Sun1

  • 1State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

Zhonghua Yi Xue Za Zhi
|April 29, 2014
PubMed

Insights

A multidisciplinary patient blood management strategy significantly reduced blood transfusions, complications, and mortality in adults undergoing valvular heart surgery. This approach conserves valuable blood resources.

Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Hematology

Context:

  • Valvular heart surgery is associated with significant allogeneic blood transfusions.
  • Patient blood management (PBM) strategies aim to optimize outcomes by minimizing transfusion needs.
  • Implementing a multidisciplinary PBM approach requires coordinated efforts across various clinical teams.

Purpose:

  • To evaluate the impact of a multidisciplinary patient blood management (PBM) strategy on valvular heart surgery outcomes.
  • To assess changes in allogeneic red blood cell transfusion rates, postoperative complications, and mortality.
  • To determine the effectiveness of PBM in conserving blood resources within a high-volume cardiac surgery center.

Summary:

  • A multidisciplinary PBM strategy, including defined transfusion triggers (Hb < 80 g/L), antifibrinolytics, cell salvage, and reduced cardiopulmonary bypass, was implemented.
  • Analysis of 3,951 valvular heart surgery patients (1,713 pre-PBM, 2,238 post-PBM) showed significant reductions in perioperative allogeneic red blood cell transfusion incidence (28.5% vs. 75.3%) and units (1.2 vs. 4.0).
  • Post-PBM outcomes included decreased postoperative length of stay (8.2 vs. 10.5 days), reduced pneumonia incidence (2.7% vs. 3.5%), and lower in-hospital mortality (0.6% vs. 1.2%).

Impact:

  • Multidisciplinary PBM significantly improves patient outcomes following valvular heart surgery by reducing transfusion requirements, morbidity, and mortality.
  • The strategy demonstrates substantial blood resource conservation.
  • This approach offers a model for enhancing patient safety and resource utilization in cardiac surgery programs.
Abstract

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