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    Blood Management in Cardiac Surgery: How to Minimize the Risks of Blood Transfusion

    "Despite the perceived benefits of transfusion, research has indicated that exposure to 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 one to two units of donor red blood cells, the impact of patient outcome is believed to be dose-dependent," David C. Fitzgerald and Joseph J. Sistino emphasize (in the new textbook "Extracorporeal Circulation").

    EXTRACORPOREAL CIRCULATION In Theory and Practice Tschaut, Rudolf J.; Dreher, Molly; Walczak, Ashley; Rosenthal, Tami

    The authors describe: "Clinical improvements in perioperative blood management can be achieved through the adoption of quality indicators and collective benchmarking. A comprehensive benchmarking process in blood management would provide participants data essential for continuous quality improvement initiatives.

    Institutional blood management is considered a team sport. Successfull implementation involves a multidisciplinary approach involving key stakeholders and institutional support. Comprehensive and multisisciplinary blood management teams are associated with the highest levels of evidence in the literature. Physicians, nurses, perfusionists and support staff across the entire continuum of care are charged with adopting and enforcing transfusion algorithms, supported with the real-time clinical data and point of care testing. Developing a broad and engaged coalition across the medical center should not be underestimated ...

    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 ..."

     

    D.C. Fitzgerald, J.J. Sistino: Blood Management.
    In: Rudolf J. Tschaut, Molly Dreher, Tami Rosenthal, Ashley Walczak (Eds.)
    Extracorporeal Circulation in Theory and Practice

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