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    Cardiac Surgery: How to minimize the risks of allogeneic blood transfusion

    "Despite the perceived benefits of transfusion, research has indicated that exposure of allogeneic blood is associated with increased risks of morbidity and mortality following cardiac surgery. Adverse postoperative clinical outcomes - such as renal failure, stroke, pulmonary dysfunction and infections - have been reported. While these complications have been linked to as few as 1-2 units of donor RBCs, the impact on patient outcome is believed to be dose-dependent. Additionally, the transfusion consequences may extend beyond hosptalization and influence long-term survival," David C. Fitzgerald and Joseph J. Sistino (Medical University of South Carolina, Charleston/USA) report in the new textbook "Extracorporeal Circulation in Theory and Practice".

    EXTRACORPOREAL CIRCULATION In Theory and Practice

    "Several randomized controlled trials have concluded that a restrictive transfusion strategy may be non-inferior to a liberal threshold in the management of perioperative anemia. As such, adequate oxygen delivery may still be accomplished while mitigating the deleterious effects of allogeneic transfusion.

    Improved cardiac surgical patient outcomes can be realized through the establishment of perioperative blood management programs. Unnecessary and uninformed blood transfusions can be avoided by the endorsement of evidence-based protocols, timely sharing of quality performance measures, and the engagement of all key stakeholders in promoting comprehensive blood management strategies. Cardiovascular perfusionists play an essential role in minimizing the potential risks of allogeneic exposure. Several interventions should be considered by the perfusion team to reduce excessive hemodilution, preserve red cell mass, and recover shed blood lost during surgery."

    Tschaut, Dreher, Rosenthal, Walczak (Eds.)
    Extracorporeal Circulation in Theory and Practice.
    Pabst, Hardcover ISBN 978-3-95853-545-9, eBook 978-3-95853-546-6

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