Perioperative Anemia and Patient Blood Management in Cardiac Surgery: A Scientific Statement From the American Heart...

Area of Science:

• Cardiology
• Anesthesiology
• Hematology

Background:

• Perioperative anemia and red blood cell transfusions are significant risk factors for morbidity and mortality in cardiac surgery.
• Preoperative anemia affects up to 50% of patients undergoing cardiac surgery.
• Iron deficiency is a primary, modifiable cause of preoperative anemia, increasing blood transfusions and negatively impacting outcomes and resource utilization.

Purpose of the Study:

• To review the latest evidence on preoperative anemia assessment and intraoperative blood conservation in cardiac surgery.
• To discuss anemia prevalence, treatment, and outcomes in specific patient populations.
• To identify key challenges and knowledge gaps in managing anemia and blood loss during cardiac surgery.

Main Methods:

• This scientific statement synthesizes current research and clinical evidence.
• It focuses on preoperative anemia assessment and intraoperative blood conservation strategies.
• The review considers specific patient populations and highlights challenges and knowledge gaps.

Main Results:

• Iron deficiency is a major contributor to preoperative anemia and subsequent blood transfusions in cardiac surgery.
• Patient blood management is a multidisciplinary approach to conserve blood and improve outcomes.
• Recent research emphasizes the importance of addressing anemia and blood loss in cardiac surgical patients.

Conclusions:

• Minimizing the impact of preoperative anemia, intraoperative blood loss, and hemodilution is essential for improving cardiac surgery outcomes.
• Effective patient blood management is critical for reducing transfusions and enhancing patient safety.
• Further research is needed to address knowledge gaps in anemia management and blood conservation.