Implementing a Preoperative Anemia Optimization Protocol for Cardiovascular Surgery Patients: A Quality Improvement...

Area of Science:

• Cardiology
• Hematology
• Perioperative Medicine

Background:

• Anemia in cardiac surgery patients is linked to worse outcomes.
• Enhanced Recovery After Surgery (ERAS) guidelines recommend preoperative optimization, including anemia treatment.
• A gap existed in standardized preoperative anemia management within a cardiothoracic surgery group.

Purpose of the Study:

• To develop and implement a standardized anemia optimization protocol for perioperative cardiac surgery patients.
• To evaluate the protocol's impact on secondary outcomes, including transfusion rates and postoperative complications.

Main Methods:

• A protocol was developed using best evidence and expert consensus from cardiac surgery and hematology specialists.
• Data were retrospectively analyzed to assess the relationship between protocol use and patient outcomes.
• The protocol was integrated into the standard consultation process for cardiac surgery patients.

Main Results:

• 42% of anemic patients received interventions through the protocol.
• The protocol group showed a lower mean transfusion requirement (1.9 U vs. 3.5 U per patient).
• In patients with acute kidney injury, the protocol group had a smaller mean creatinine increase (0.65 mg/dL vs. 1.52 mg/dL).

Conclusions:

• Preoperative anemia management protocol may mitigate risks associated with cardiac surgery.
• Protocol implementation demonstrated reduced packed red blood cell transfusions and a trend towards less severe acute kidney injury.
• Continued use of the anemia optimization protocol is recommended for cardiac surgery patients.