The impact of a multidisciplinary blood conservation protocol on patient outcomes and cost after cardiac surgery

Ad, Niv; Holmes, Sari D.; Patel, Jigar; Shuman, Deborah J.; Massimiano, Paul S.; Choi, Elmer; Fitzgerald, David; Halpin, Linda; Fornaresio, Lisa M.

doi:10.1016/j.jtcvs.2016.10.083

Cited by 31 publications

(28 citation statements)

References 48 publications

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“…A key component of reducing blood utilization is the development of a teambased approach to blood conservation [12]. Simple things such as reducing the number of blood draws, trying to convert patients to more elective procedures, and reducing the dilutional effects associated with administration of excessive intravenous fluid all can contribute significantly to reductions in surgical blood loss.…”

Section: Blood Conservation Programsmentioning

confidence: 99%

The Role of Biosurgical Hemostatic Sealants in Cardiac Surgery

Firstenberg¹,

Hanna²,

Stawicki³

2020

Biosurgicals - The Next Frontier in Operative Approaches [Working Title]

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The focus on superb quality and value of medical and surgical care has become a cornerstone of modern clinical practice. Within the realm of cardiothoracic surgery, quality is synonymous with technically excellent, safely conducted operative procedure followed by an uneventful patient recovery and follow-up. Critical to this process of clinical value creation is meticulous attention to all aspects of every step along the management continuum. From surgical quality improvement perspective, the reduction in blood loss and thus minimization of blood/blood product transfusions are of critical importance. This chapter focuses on the role of biosurgicals as useful adjuncts to achieving the ultimate goal of uneventful cardiac procedure and thus set the patient's clinical course for optimal postoperative recovery and longterm well-being.

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Section: Blood Conservation Programsmentioning

confidence: 99%

The Role of Biosurgical Hemostatic Sealants in Cardiac Surgery

Firstenberg¹,

Hanna²,

Stawicki³

2020

Biosurgicals - The Next Frontier in Operative Approaches [Working Title]

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“…Excellent single-center results of a multidisciplinary approach towards minimization of RBC transfusion have been published elsewhere [22]. The ONTraC program differs in that it is a hematology-led, nurse-driven, guideline-based approach.…”

Section: Commentmentioning

confidence: 99%

“…Despite uniform support for the use of blood conservation strategies at the time of cardiac operation, such methods are underutilized [20,21]. Furthermore, few approaches have instituted a largescale multidisciplinary approach to replace blood conservation with patient blood management including hematologists and front-line nurses [22,23].…”

mentioning

confidence: 99%

Hemoglobin Optimization for Coronary Bypass: A 10-Year Canadian Multicenter Experience

Yanagawa

Rocha

Mazine

et al. 2019

The Annals of Thoracic Surgery

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“…Ad et al 35 used a BCS involving expanded use of cell salvage blood in place of cardiotomy suction, acute normovolemic hemodilution, and retrograde autologous priming. Their protocol showed a reduction in the use of blood products from 54 to 25% (p ¼ 0.001), as well as a lower incidence of postoperative renal failure (4-2.6%; p ¼ 0.04), reoperation for bleeding (4-2%; p ¼ 0.004), and 30-day readmission (12-6%; p < 0.001), with no difference in operative mortality.…”

Section: Blood Conservation Strategies In Cardiac and Aortic Surgerymentioning

confidence: 99%

The Effect of Blood Transfusion on Outcomes in Aortic Surgery

et al. 2017

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The use of blood transfusion in cardiac surgery varies widely. The beneficial effects of blood products are offset by an increase in morbidity and mortality. Despite multiple studies showing an association between blood product exposure and adverse short- and long-term events, it is difficult to determine causality. Nevertheless, the implication is sufficient to warrant the search for alternative strategies to reduce the use of blood products while providing a standard of care that optimizes postoperative outcomes. Aortic surgery, in particular, is associated with an increased risk of bleeding requiring a blood transfusion. There is a paucity of evidence within aortic surgery regarding the deleterious effects of blood products. Here, we review the current evidence regarding patient outcomes after blood transfusion in cardiac surgery, with special emphasis on aortic surgery.

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The impact of a multidisciplinary blood conservation protocol on patient outcomes and cost after cardiac surgery

Cited by 31 publications

References 48 publications

The Role of Biosurgical Hemostatic Sealants in Cardiac Surgery

The Role of Biosurgical Hemostatic Sealants in Cardiac Surgery

Hemoglobin Optimization for Coronary Bypass: A 10-Year Canadian Multicenter Experience

The Effect of Blood Transfusion on Outcomes in Aortic Surgery

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