title: Blood conservation in cardiac surgery: let's get restrictive.
abstract: Despite increasing evidence suggesting harmful effects of blood transfusions, physician practices are slow to change. A systematic approach is required to successfully minimize the need for red cell transfusions in the perioperative cardiac surgical patient. This involves preoperative, intraoperative, and postoperative strategies to minimize blood loss and maximize blood conservation. In addition it requires physician education regarding the potential deleterious effects of blood and the more recent evidence that restrictive transfusion strategies are safe and possibly beneficial to postoperative surgical outcomes. In this article, we review the data with respect to blood transfusions in cardiac surgery patients as well as management strategies to minimize the need for blood transfusions in the perioperative period.
authors.affiliation: Department of Cardiothoracic Surgery, The Mount Sinai Medical Center, Mount Sinai School of Medicine, New York, New York 10029, USA. robin.varghese@mountsinai.org
authors.forename: Robin
authors.initials: R
authors.lastname: Varghese
authors.forename: M Lee
authors.initials: ML
authors.lastname: Myers
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D006801:Humans; D007430:Intraoperative Care; D011182:Postoperative Care; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011300:Preoperative Care; D018570:Risk Assessment; D012307:Risk Factors; D065227:Transfusion Reaction