Current State of Patient Blood Management in Cardiovascular Surgery: Insights from a Survey of Leading Centers

Area of Science:

• Cardiovascular Surgery
• Patient Blood Management
• Healthcare Quality Improvement

Background:

• Patient blood management (PBM) is crucial for optimizing outcomes in cardiac surgery.
• Leading cardiac surgery centers are expected to implement comprehensive PBM strategies.
• Current PBM practices in top US centers require evaluation.

Purpose of the Study:

• To assess the current state of patient blood management (PBM) implementation in leading US cardiac surgery centers.
• To identify variations in PBM program structure and operational practices.
• To evaluate the adoption of specific blood conservation techniques and protocols.

Main Methods:

• A survey was distributed to the top 25 US cardiac surgery centers (US News and World Report 2024).
• The survey addressed PBM program structure, operations, and management of clinical scenarios.
• Data collected included staffing, informed consent procedures, anemia screening, and blood conservation techniques.

Main Results:

• Only 29% of centers had dedicated full-time equivalents for PBM.
• Informed consent practices for transfusion varied significantly.
• While advanced blood conservation techniques were common, simpler measures like adjusting cardiopulmonary bypass circuits were less utilized (43%).

Conclusions:

• Many leading cardiac surgery centers lack key components of robust patient blood management programs.
• There is a substantial opportunity to enhance and expand PBM practices within cardiovascular surgery.
• Improving PBM implementation can lead to better patient outcomes and resource utilization.