Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients

Jacob Raphael, C. David Mazer, Sudhakar Subramani, Andrew Schroeder, Mohamed Abdalla, Renata Ferreira, Philip E. Roman, Nichlesh Patel, Ian Welsby, Philip E. Greilich, Reed Harvey, Marco Ranucci, Lori B. Heller, Christa Boer, Andrew Wilkey, Steven E. Hill, Gregory A. Nuttall, Raja R. Palvadi, Prakash A. Patel, Barbara WilkeyBrantley Gaitan, Shanna S. Hill, Jenny Kwak, John Klick, Bruce A. Bollen, Linda Shore-Lesserson, James Abernathy, Nanette Schwann, W. Travis Lau

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1209-1221
Number of pages13
JournalAnesthesia and analgesia
Volume129
Issue number5
DOIs
StatePublished - Nov 1 2019

Bibliographical note

Funding Information:
Name: Jacob Raphael, MD. Contribution: This author helped with study design, data collection and analysis, and in writing the manuscript. Conflicts of Interest: J. Raphael received research grant from OctaPharma. Name: C. David Mazer, MD. Contribution: This author helped with study design, data collection and analysis, and in writing the manuscript. Conflicts of Interest: C. D. Mazer received research grants to institution and/or consulting honoraria from AlloCure Inc, Amgen, Boehringer Ingelheim, CSL Behring, OctaPharma, Quark Pharmaceuticals, Tenax Therapeutics, and Thrasos Innovation. Name: Sudhakar Subramani, MD. Contribution: This author helped with study design and data collection. Conflicts of Interest: None. Name: Andrew Schroeder, MD. Contribution: This author helped with study design and data collection. Conflicts of Interest: None. Name: Mohamed Abdalla, MD. Contribution: This author helped with study design and data collection. Conflicts of Interest: None. Name: Renata Ferreira, MD. Contribution: This author helped with study design, data collection and analysis, and in writing the manuscript. Conflicts of Interest: None. Name: Philip E. Roman, MD. Contribution: This author helped with study design and data collection and analysis. Conflicts of Interest: None. Name: Nichlesh Patel, MD. Contribution: This author helped with data collection and analysis and reviewing the manuscript. Conflicts of Interest: None. Name: Ian Welsby, MBBS. Contribution: This author helped with study design and data collection and analysis. Conflicts of Interest: I. Welsby received research grant from CSL Behring. Name: Philip E. Greilich, MD. Contribution: This author helped with study design and data collection and analysis. Conflicts of Interest: P. E. Greilich research funding from AMAG Pharmaceuticals (IV iron supplementation). Name: Reed Harvey, MD. Contribution: This author helped with data collection and analysis and reviewing the manuscript. Conflicts of Interest: None. Name: Marco Ranucci, MD.

Funding Information:
Contribution: This author helped with study design, data collection and analysis, and reviewing the manuscript. Conflicts of Interest: M. Ranucci received consultancy fees for Haemonetics and Medtronic; speaker’s fees from Werfen, CSL Behring, and Grifols; and research grants from Roche Diagnostics, Hemosonics, and Werfen CSL Behring. Name: Lori B. Heller, MD. Contribution: This author helped with study design and data collection and analysis. Conflicts of Interest: None. Name: Christa Boer, MD. Contribution: This author helped with study design, data collection and analysis, and reviewing the manuscript. Conflicts of Interest: None. Name: Andrew Wilkey, MD. Contribution: This author helped with study design, data collection and analysis, and in writing the manuscript. Conflicts of Interest: None. Name: Steven E. Hill, MD. Contribution: This author helped with study design and data collection and analysis. Conflicts of Interest: None. Name: Gregory A. Nuttall, MD. Contribution: This author helped with study design and data collection and analysis. Conflicts of Interest: None. Name: Raja R. Palvadi, MD. Contribution: This author helped with data collection and analysis and reviewing the manuscript. Conflicts of Interest: None. Name: Prakash A. Patel, MD. Contribution: This author helped with data collection and analysis and reviewing the manuscript. Conflicts of Interest: None. Name: Barbara Wilkey, MD. Contribution: This author helped with study design data collection and analysis and reviewing the manuscript. Conflicts of Interest: None. Name: Brantley Gaitan, MD. Contribution: This author helped with study design, data collection and analysis, and reviewing the manuscript. Conflicts of Interest: None. Name: Shanna S. Hill, MD. Contribution: This author helped with data collection and analysis and reviewing the manuscript. Conflicts of Interest: None. Name: Jenny Kwak, MD. Contribution: This author helped with data collection and analysis and reviewing the manuscript. Conflicts of Interest: None. Name: John Klick, MD. Contribution: This author helped with data collection and analysis and reviewing the manuscript. Conflicts of Interest: None. Name: Bruce A. Bollen, MD. Contribution: This author helped with study design, data analysis, and in writing the manuscript. Conflicts of Interest: None. Name: Linda Shore-Lesserson, MD. Contribution: This author helped with study design, data collection and analysis, and in writing the manuscript. Conflicts of Interest: None. Name: James Abernathy, MD. Contribution: This author helped with data collection and analysis and reviewing the manuscript. Conflicts of Interest: None. Name: Nanette Schwann, MD. Contribution: This author helped with study design, data analysis, and in writing the manuscript. Conflicts of Interest: None. Name: W. Travis Lau, MD. Contribution: This author helped with study design, data collection and analysis, and in writing the manuscript. Conflicts of Interest: None. This manuscript was handled by: Roman M. Sniecinski, MD.

Fingerprint Dive into the research topics of 'Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients'. Together they form a unique fingerprint.

Cite this