Consensus Report on Patient Blood Management in Cardiac Surgery by Turkish Society of Cardiovascular Surgery (TSCVS), Turkish Society of Cardiology (TSC), and Society of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care (SCTAIC)

Abstract

Anemi, transfüzyon ve kanama kalp cerrahisinde bağımsız olarak komplikasyon ve mortalite riskini artırır. Hasta kan yönetiminin başlıca amacı perioperatif dönemde aneminin tedavisi, kanamanın önlenmesi ve kan ürünü kullanımının optimize edilmesidir. Bu programın yararı birçok çalışmada kanıtlanmış olup, kullanımı birçok mesleki dernek tarafından önemle önerilmektedir. Bu uzlaşı raporu, Türk Kalp Damar Cerrahisi Derneği (TKDCD), Türk Kardiyoloji Derneği (TKD) ve Göğüs-Kalp-Damar Anestezi ve Yoğun Bakım Derneği'nin çalışma grubu üyeleri tarafından hasta kan yönetimine ilişkin farkındalığı artırmak amacıyla hazırlanmıştır. Bu raporda, kalp cerrahisinde perioperatif dönemde kan koruyucu stratejilerin tümüne ilişkin öneriler özetlenmiştir.Anah tar söz cük ler: Kalp cerrahisi, hasta kan yönetimi, transfüzyon, kanama.

Cost-Effectiveness and Budget Impact of Comprehensive Anemia Management, The First Pillar of Patient Blood Management, on the Turkish Healthcare System

“…In 2019, The Turkish Society of Cardiovascular Surgery, Turkish Society of Cardiology and Society of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care published a consensus report on PBM in cardiac surgery. 20 To date, these are the only structured guidelines that focus on blood-conservation strategies with recommendations in line with global guidelines and practice.…”

Patient blood management strategies in vascular surgery

“…The hemoglobin value is vital when deciding on blood transfusion, but it should not be the only criterion; age, associated comorbidities, duration of anemia, the possibility of perioperative blood loss, and the type and duration of the operation should also be considered. If hemoglobin level can be increased with hematinic drugs, such as iron, folic acid, and vitamin B12, and the patient does not have symptoms, transfusion is not required [17][18][19]. Transfusion of packed RBCs should be reserved for patients who are actively bleeding or have severe and symptomatic anemia (Table 1).…”

“…Vitamin K antagonists are mainly indicated in patients with mechanical heart valves, atrial fibrillation accompanying rheumatic mitral valvular stenosis. For those patients, direct oral anticoagulant therapy is associated with a worse outcome compared to VKA therapy [19][20][21][22]. Current guidelines recommend that VKAs should be stopped three to five days before surgery to obtain an international normalized ratio ≤1.5 [19,23].…”

“…For those patients, direct oral anticoagulant therapy is associated with a worse outcome compared to VKA therapy [19][20][21][22]. Current guidelines recommend that VKAs should be stopped three to five days before surgery to obtain an international normalized ratio ≤1.5 [19,23]. Perioperative management of VKA depends on the urgency of surgery and the estimated amount of perioperative bleeding.…”

The Effects of Iron Therapy on Blood Transfusion, Length of Intensive Care Stay and Mortality in Patients with Iron Deficiency Anemia in the Intensive Care Unit

“…To manage IDA, inexpensive, effective, and reliable oral iron supplements are used. [3] In the literature, doses higher than 60-120 mg of elemental iron per day are not recommended because they are unlikely to offer significant benefit in terms of iron repletion and can cause unintended side effects. [4] It has been reported that providing iron supplements daily as divided doses increases serum hepcidin and reduces iron absorption, and daily oral iron supplements are more effective as a single dose.…”