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Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients.
Anesthesia and analgesia
  • Jacob Raphael, University of Virginia Health System
  • C David Mazer, University of Toronto
  • Sudhakar Subramani, University of Iowa
  • Andrew Schroeder, University of Wisconsin-Madison
  • Mohamed Abdalla, Cleveland Clinic Lerner Research Institute
  • Renata Ferreira, University of Washington Medical Center
  • Philip E Roman, Centura St Anthony Hospital
  • Nichlesh Patel, University of California, San Francisco
  • Ian Welsby, Duke University Hospital
  • Philip E Greilich, UT Southwestern Medical Center
  • Reed Harvey, UCLA Medical Center
  • Marco Ranucci, IRCCS Policlinico San Donato
  • Lori B Heller, Swedish Medical Center
  • Christa Boer, VU University Medical Center
  • Andrew Wilkey, Abbott Northwestern Hospital
  • Steven E Hill, UT Southwestern Medical Center
  • Gregory A Nuttall, Mayo Clinic
  • Raja R Palvadi, Baylor College of Medicine
  • Prakash A Patel, University of Pennsylvania
  • Barbara Wilkey, University of Colorado
  • Brantley Gaitan, Mayo Clinic
  • Shanna S Hill, Weill Cornell Medical Center
  • Jenny Kwak, Loyola University Medical Center
  • John Klick, Case Western Reserve University
  • Bruce A Bollen, Missoula Anesthesiology
  • Linda Shore-Lesserson, Zucker School of Medicine at Hofstra/Northwell
  • James Abernathy, Johns Hopkins Medical Center
  • Nanette M. Schwann, M.D., Lehigh Valley Health Network
  • W Travis Lau, Pacific Anesthesia
Publication/Presentation Date
11-1-2019
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 (POC) coagulation monitors and the use of novel therapeutic strategies for perioperative hemostasis, such as the use of coagulation factor concentrates, have 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 only modestly declined over the last decade, remaining at ≥50% in high-risk patients. Given these limitations, and in response to new regulatory and legislature requirements, the Society of Cardiovascular Anesthesiologists (SCA) has formed the Blood Conservation in Cardiac Surgery Working Group 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.

PubMedID
31613811
Document Type
Article
Citation Information

Raphael, J., Mazer, C. D., Subramani, S., Schroeder, A., Abdalla, M., Ferreira, R., Roman, P. E., Patel, N., Welsby, I., Greilich, P. E., Harvey, R., Ranucci, M., Heller, L. B., Boer, C., Wilkey, A., Hill, S. E., Nuttall, G. A., Palvadi, R. R., Patel, P. A., Wilkey, B., … Lau, W. T. (2019). Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients. Anesthesia and analgesia, 129(5), 1209–1221. https://doi.org/10.1213/ANE.0000000000004355