Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients
Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research...
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Published in | Journal of cardiothoracic and vascular anesthesia Vol. 33; no. 11; pp. 2887 - 2899 |
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Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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United States
Elsevier Inc
01.11.2019
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Subjects | |
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Abstract | Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research has revealed that adherence to these guidelines is poor, and as a result, a significant variability in patient transfusion practices among practitioners still remains. In addition, although utilization of point of care coagulation monitors and the use of novel therapeutic strategies for perioperative hemostasis, such as the use of coagulation factor concentrates, has increased significantly over the last decade, they are still not widely available in every institution. Therefore, despite continuous efforts, blood transfusion in cardiac surgery has declined only modestly over the last decade, remaining at 50% or greater in high-risk patients.
Given these limitations and in response to new regulatory and legislature requirements, the Society of Cardiovascular Anesthesiologists has formed the Blood Conservation in Cardiac Surgery Working Group in order to organize, summarize, and disseminate the available best-practice knowledge in patient blood management in cardiac surgery. The current publication includes the summary statements and algorithms designed by the working group, after collection and review of the existing guidelines, consensus statements, and recommendations for patient blood management practices in cardiac surgery patients. The overall goal is creating a dynamic resource of easily accessible educational material that will help to increase and improve compliance with the existing evidence-based best practices of patient blood management by cardiac surgery care teams. |
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AbstractList | Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research has revealed that adherence to these guidelines is poor, and as a result, a significant variability in patient transfusion practices among practitioners still remains. In addition, although utilization of point of care coagulation monitors and the use of novel therapeutic strategies for perioperative hemostasis, such as the use of coagulation factor concentrates, has increased significantly over the last decade, they are still not widely available in every institution. Therefore, despite continuous efforts, blood transfusion in cardiac surgery has declined only modestly over the last decade, remaining at 50% or greater in high-risk patients. Given these limitations and in response to new regulatory and legislature requirements, the Society of Cardiovascular Anesthesiologists has formed the Blood Conservation in Cardiac Surgery Working Group in order to organize, summarize, and disseminate the available best-practice knowledge in patient blood management in cardiac surgery. The current publication includes the summary statements and algorithms designed by the working group, after collection and review of the existing guidelines, consensus statements, and recommendations for patient blood management practices in cardiac surgery patients. The overall goal is creating a dynamic resource of easily accessible educational material that will help to increase and improve compliance with the existing evidence-based best practices of patient blood management by cardiac surgery care teams. Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research has revealed that adherence to these guidelines is poor, and as a result, a significant variability in patient transfusion practices among practitioners still remains. In addition, although utilization of point of care coagulation monitors and the use of novel therapeutic strategies for perioperative hemostasis, such as the use of coagulation factor concentrates, has increased significantly over the last decade, they are still not widely available in every institution. Therefore, despite continuous efforts, blood transfusion in cardiac surgery has declined only modestly over the last decade, remaining at 50% or greater in high-risk patients. Given these limitations and in response to new regulatory and legislature requirements, the Society of Cardiovascular Anesthesiologists has formed the Blood Conservation in Cardiac Surgery Working Group in order to organize, summarize, and disseminate the available best-practice knowledge in patient blood management in cardiac surgery. The current publication includes the summary statements and algorithms designed by the working group, after collection and review of the existing guidelines, consensus statements, and recommendations for patient blood management practices in cardiac surgery patients. The overall goal is creating a dynamic resource of easily accessible educational material that will help to increase and improve compliance with the existing evidence-based best practices of patient blood management by cardiac surgery care teams. |
Author | Subramani, Sudhakar Boer, Christa Gaitan, Brantley Roman, Philip E. Hill, Shanna S. Bollen, Bruce A. Nuttall, Gregory A. Kwak, Jenny Mazer, C. David Patel, Prakash A. Palvadi, Raja R. Wilkey, Barbara Klick, John Ferreira, Renata Raphael, Jacob Greilich, Philip E. Abernathy, James Welsby, Ian Lau, W. Travis Abdalla, Mohamed Patel, Nichlesh Harvey, Reed Heller, Lori B. Schroeder, Andrew Hill, Steven E. Shore-Lesserson, Linda Schwann, Nanette Wilkey, Andrew Ranucci, Marco |
Author_xml | – sequence: 1 givenname: Jacob surname: Raphael fullname: Raphael, Jacob email: Jr5ef@virginia.edu organization: University of Virginia Health System, Charlottesville, VA – sequence: 2 givenname: C. David surname: Mazer fullname: Mazer, C. David organization: St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada – sequence: 3 givenname: Sudhakar surname: Subramani fullname: Subramani, Sudhakar organization: University of Iowa, Iowa City, IA – sequence: 4 givenname: Andrew surname: Schroeder fullname: Schroeder, Andrew organization: University of Wisconsin Medical Center, Madison, WI – sequence: 5 givenname: Mohamed surname: Abdalla fullname: Abdalla, Mohamed organization: Cleveland Clinic, Cleveland, OH – sequence: 6 givenname: Renata surname: Ferreira fullname: Ferreira, Renata organization: University of Washington Medical Center, Seattle, WA – sequence: 7 givenname: Philip E. surname: Roman fullname: Roman, Philip E. organization: Centura St. Anthony Hospital, Lakewood, CO – sequence: 8 givenname: Nichlesh surname: Patel fullname: Patel, Nichlesh organization: University of California San Francisco, San Francisco, CA – sequence: 9 givenname: Ian surname: Welsby fullname: Welsby, Ian organization: Duke University Hospital, Durham, NC – sequence: 10 givenname: Philip E. surname: Greilich fullname: Greilich, Philip E. organization: UT Southwestern Medical Center, Dallas, TX – sequence: 11 givenname: Reed surname: Harvey fullname: Harvey, Reed organization: UCLA Medical Center, Los Angeles, CA – sequence: 12 givenname: Marco surname: Ranucci fullname: Ranucci, Marco organization: IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy – sequence: 13 givenname: Lori B. surname: Heller fullname: Heller, Lori B. organization: Swedish Medical Center, Seattle, WA – sequence: 14 givenname: Christa surname: Boer fullname: Boer, Christa organization: VU University Medical Center, Amsterdam, Netherlands – sequence: 15 givenname: Andrew surname: Wilkey fullname: Wilkey, Andrew organization: Abbott Northwestern Hospital, Minneapolis, MN – sequence: 16 givenname: Steven E. surname: Hill fullname: Hill, Steven E. organization: UT Southwestern Medical Center, Dallas, TX – sequence: 17 givenname: Gregory A. surname: Nuttall fullname: Nuttall, Gregory A. organization: Mayo Clinic, Rochester, MN – sequence: 18 givenname: Raja R. surname: Palvadi fullname: Palvadi, Raja R. organization: Baylor College of Medicine, Houston, TX – sequence: 19 givenname: Prakash A. surname: Patel fullname: Patel, Prakash A. organization: University of Pennsylvania Medical Center, Philadelphia, PA – sequence: 20 givenname: Barbara surname: Wilkey fullname: Wilkey, Barbara organization: University of Colorado, Denver, CO – sequence: 21 givenname: Brantley surname: Gaitan fullname: Gaitan, Brantley organization: Mayo Clinic, Phoenix, AZ – sequence: 22 givenname: Shanna S. surname: Hill fullname: Hill, Shanna S. organization: Weill Cornell Medical Center, New York, NY – sequence: 23 givenname: Jenny surname: Kwak fullname: Kwak, Jenny organization: Loyola University Medical Center, Maywood, IL – sequence: 24 givenname: John surname: Klick fullname: Klick, John organization: Case Western University Medical Center, Cleveland, OH – sequence: 25 givenname: Bruce A. surname: Bollen fullname: Bollen, Bruce A. organization: Missoula Anesthesiology, Missoula, MT – sequence: 26 givenname: Linda surname: Shore-Lesserson fullname: Shore-Lesserson, Linda organization: Zucker School of Medicine at Hofstra/Northwell, Northshore University Hospital, Manhasset, New York, NY – sequence: 27 givenname: James surname: Abernathy fullname: Abernathy, James organization: Johns Hopkins Medical Center, Baltimore, MD – sequence: 28 givenname: Nanette surname: Schwann fullname: Schwann, Nanette organization: Lehigh Valley Health Network, University of South Florida Morsani College of Medicine, Tampa, FL – sequence: 29 givenname: W. Travis surname: Lau fullname: Lau, W. Travis organization: Pacific Anesthesia, Honolulu, HI |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31604540$$D View this record in MEDLINE/PubMed |
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SubjectTerms | bleeding cardiac anesthesia cardiac surgery hemostasis Transfusion |
Title | Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients |
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