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

Citation
P. Van Der Linden et al., A standardized multidisciplinary approach reduces the use of allogeneic blood products in patients undergoing cardiac surgery, CAN J ANAES, 48(9), 2001, pp. 894-901
Citations number
36
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Journal title
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE
ISSN journal
0832-610X → ACNP
Volume
48
Issue
9
Year of publication
2001
Pages
894 - 901
Database
ISI
SICI code
0832-610X(200110)48:9<894:ASMART>2.0.ZU;2-G
Abstract
Purpose: Individual and institutional practices remain an independent predi ctor factor for allogeneic blood transfusion. Application of a standardized multidisciplinary transfusion strategy should reduce the use of allogeneic blood transfusion in major surgical patients. Methods: This prospective non randomized observational study evaluated the effects of a standardized multidisciplinary transfusion strategy on allogen eic blood products exposure in patients undergoing non-emergent cardiac sur gery. The developed strategy involved a standardized blood conservation pro gram and a multidisciplinary allogeneic blood transfusion policy based main ly on clinical judgement, not only on a specific hemoglobin concentration. Data obtained in a first group including patients operated from September 1 997 to August 1998 (Group pre: n=321), when the transfusion strategy was pr ogressively developed, were compared to those obtained in a second group, i ncluding patients operated from September 1998 to August 1999 (Group post: n = 315) when the transfusion strategy was applied uniformly. Results: Patient populations and surgical procedures were similar. Patients in Group post underwent acute normovolemic hemodilution more frequently, h ad a higher core temperature at arrival in the intensive care unit and pres ented lower postoperative blood losses at day one. Three hundred forty unit s of packed red blood cells were transfused in 33% of the patients in Group pre whereas 161 units were transfused in 18% of the patients in Group post (P < 0.001). Pre- and postoperative hemoglobin concentrations, mortality a nd morbidity were not different among groups, Conclusion: Development of a standardized multidisciplinary transfusion str ategy markedly reduced the exposure of cardiac surgery patients to allogene ic blood.