Transfusion algorithms and how they apply to blood conservation: the high-risk cardiac surgical patient.
Considerable blood product support is administered to the cardiac surgery population. Due to the multifactorial etiology of bleeding in the cardiac bypass patient, blood products frequently and empirically are infused to correct bleeding, with varying success. Several studies have demonstrated the benefit of algorithm-guided transfusion in reducing blood loss, transfusion exposure, or rate of surgical re-exploration for bleeding. Some transfusion algorithms also incorporate laboratory-based decision points in their guidelines. Despite published success with standardized transfusion practices, generalized change in blood use has not been realized, and it is evident that current laboratory-guided hemostasis measures are inadequate to define and address the bleeding etiology in these patients.
Steiner
Marie E
ME
Department of Pediatrics, Division of Hematology/Oncology/Blood & Marrow Transplantation, 420 Delaware Street, MMC 484, University of Minnesota, Minneapolis, MN 55455, USA. stein083@umn.edu
Despotis
George John
GJ
D000465:Algorithms; D001793:Blood Preservation; D001803:Blood Transfusion; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D006801:Humans; D012307:Risk Factors