Blood conservation strategies in cardiovascular surgery.
Blood conservation is a measurable intervention in which clinical and financial outcomes may be tracked. This article describes a systems approach to blood conservation for a cardiac surgery population. Four key areas are discussed: needs assessment, committee construction, blood conservation strategies, and outcome measurement. Specific evidenced-based blood conservation strategies include, but are not limited to, transfusion risk index, phlebotomy techniques, management of hemostasis and hemoglobin levels which includes blood testing, pharmacologic agents, and blood transfusion prescription guidelines.
Maglish Ehrman
Barbara L
BL
St Vincent Hospital & Health, Indianapolis, Indiana, USA. blehrman@stvincent.org
Moore
Holly A
HA
D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001800:Blood Specimen Collection / Q000379:methods / Q000592:standards; D001803:Blood Transfusion / Q000592:standards / Q000706:statistics & numerical data; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects*; D004921:Erythropoietin / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D006454:Hemoglobins / Q000032:analysis; D006490:Hemostatics / Q000627:therapeutic use; D006494:Heparin Antagonists / Q000627:therapeutic use; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods / Q000592:standards; D020380:Needs Assessment; D017063:Outcome Assessment, Health Care; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D055656:Prescriptions / Q000592:standards / Q000706:statistics & numerical data; D011367:Professional Staff Committees; D011479:Protamines / Q000627:therapeutic use; D018570:Risk Assessment; D013597:Systems Analysis; D065227:Transfusion Reaction
D006454:Hemoglobins; D006490:Hemostatics; D006494:Heparin Antagonists; D010975:Platelet Aggregation Inhibitors; D011479:Protamines; D004921:Erythropoietin