Comprehensive Multimodality Blood Conservation: 100 Consecutive CABG Operations Without Transfusion

A standardized multidisciplinary approach reduces the use of allogeneic blood products in patients undergoing cardiac surgery

“…14 However, several studies tend to demonstrate its efficacy after cardiac surgery. [14][15][16] This technique constituted a major component of our intraoperative blood conservation program. Both the number of patients and the volume of blood collected were increased.…”

Perioperative blood conservation — The experts, the elephants, the clinicians, and the gauntlet

“…In recommending the use of multi-modality blood conservation strategies, clinical guidelines often cite studies that found such strategies to be highly efficacious in reducing exposure to allogeneic blood transfusions. 14,15 These and other similar studies, however, have important limitations -often, they are small, single-centre studies that lack proper controls or blinding -that may limit their generalizability. In the first rigorous examination of such strategies, Feagan and associates randomized 30 hospitals to implement a multi-modality blood conservation strategy or to continue with standard care (which included the use of autologous predonation in about 25% of cases) in orthopedic surgery patients.…”

“…Dans leurs recommandations au sujet de l'utilisation de stratégies multimodales de conservation du sang, les directives cliniques citent souvent des études qui ont démontré que de telles stratégies étaient très efficaces dans la réduction de l'exposition des patients aux transfusions de sang allogène. 14,15 Ces études -ainsi que d'autres allant dans la même direction -comportent toutefois des limitations importantes : souvent, elles sont de petite échelle et réalisées dans un seul centre, ce qui a pour résultat qu'elles manquent des contrôles et techniques en aveugle adéquats. Pour cette raison, leur potentiel de généralisation est limité.…”

SCT in Jehovah's Witnesses: the bloodless transplant

“…Yet it is an obligation of the medical community to serve the needs of patients in a manner consistent with their beliefs. In areas such as cardiac surgery 1 and liver transplantation, 2 techniques developed out of necessity for JWs may have improved care for routine patients. There are several opportunities to minimize transplant-related morbidity and mortality in patients determined to undergo SCT without receiving plasma, RBCs or plts.…”