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Blood Management in High-risk Surgery

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Blood transfusion is critical to cardiothoracic operations and other complex surgical procedures. Optimal patient blood management is standard care that minimizes perioperative blood loss and mitigates both anemia and excessive allogeneic blood transfusion.1

The guideline was developed by a multidisciplinary panel of experts convened by the STS comprising members of the SCA, the AmSECT, and the SABM.2 The panel reviewed contemporary literature on patient blood management. All panel experts submitted conflict of interest disclosure forms, which were reviewed by the committee chair and STS staff. There were no relevant relationships with industry for any committee member (Table). The document was reviewed by the STS Workforce on Evidence-Based Surgery, the STS Council Operating Board on Quality, Research, and Patient Safety, and the Executive Committee. A 2-week member comment period was provided to the participating societies for feedback. The final document was reviewed by the boards of directors of the SCA and AmSECT prior to publication. The participating societies developed the guidelines without commercial support.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Arnar Geirsson, MD, Division of Cardiac Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar St, New Haven, CT 06510 (arnar.geirsson@yale.edu).

Conflict of Interest Disclosures: None reported.

References
1.
Frietsch  T , Shander  A , Faraoni  D , Hardy  JF .  Patient blood management is not about blood transfusion: it is about patients’ outcomes.   Blood Transfus. 2019;17(5):331-333. doi:10.2450/2019.0126-19PubMedGoogle Scholar
2.
Tibi  P , McClure  RS , Huang  J ,  et al.  STS/SCA/AmSECT/SABM update to the clinical practice guidelines on patient blood management.   Ann Thorac Surg. 2021;112(3):981-1004. doi:10.1016/j.athoracsur.2021.03.033PubMedGoogle ScholarCrossref
3.
Ferraris  VA , Brown  JR , Despotis  GJ ,  et al; Society of Thoracic Surgeons Blood Conservation Guideline Task Force; Society of Cardiovascular Anesthesiologists Special Task Force on Blood Transfusion; International Consortium for Evidence Based Perfusion.  2011 update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines.   Ann Thorac Surg. 2011;91(3):944-982. doi:10.1016/j.athoracsur.2010.11.078PubMedGoogle ScholarCrossref
4.
Myles  PS , Smith  JA , Forbes  A ,  et al; ATACAS Investigators of the ANZCA Clinical Trials Network.  Tranexamic acid in patients undergoing coronary-artery surgery.   N Engl J Med. 2017;376(2):136-148. doi:10.1056/NEJMoa1606424PubMedGoogle ScholarCrossref
5.
Shehata  N , Mistry  N , da Costa  BR ,  et al.  Restrictive compared with liberal red cell transfusion strategies in cardiac surgery: a meta-analysis.   Eur Heart J. 2019;40(13):1081-1088. doi:10.1093/eurheartj/ehy435PubMedGoogle ScholarCrossref
6.
Mueller  MM , Van Remoortel  H , Meybohm  P ,  et al; ICC PBM Frankfurt 2018 Group.  Patient blood management: recommendations from the 2018 Frankfurt Consensus Conference.   JAMA. 2019;321(10):983-997. doi:10.1001/jama.2019.0554PubMedGoogle ScholarCrossref
7.
Corredor  C , Wasowicz  M , Karkouti  K , Sharma  V .  The role of point-of-care platelet function testing in predicting postoperative bleeding following cardiac surgery: a systematic review and meta-analysis.   Anaesthesia. 2015;70(6):715-731. doi:10.1111/anae.13083PubMedGoogle ScholarCrossref
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