Effect of the Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery Clinical Practice Guidelines of the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists upon Clinical Practices

Likosky, Donald S.; FitzGerald, Daniel C.; Groom, Robert C.; Jones, Dwayne K.; Baker, Robert A.; Shann, Kenneth G.; Mazer, C. David; Spiess, Bruce D.; Body, Simon C.

doi:10.1213/ane.0b013e3181e329f1

Cited by 83 publications

(55 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…AmSECT was involved in preparation of the blood transfusion management guidelines established by the collaboration of 2 academic societies, 10) and the temperature management guidelines for extracorporeal circulation were prepared in 2015 by the collaboration of 3 academic societies. 11) In addition, the registration items of extracorporeal circulation cases were reflected in the standard extracorporeal circulation techniques published by AmSECT and guidelines, 12) showing that the summation and analysis by the registration of extracorporeal circulation cases are admitted as scientific evidence.…”

Section: ⅲ．Discussionmentioning

confidence: 99%

Study profile of the perfusion registry in Japan

Hibiya

Kamei

Kubota

et al. 2018

JJECT

View full text Add to dashboard Cite

show abstract

Section: ⅲ．Discussionmentioning

confidence: 99%

Study profile of the perfusion registry in Japan

Hibiya

Kamei

Kubota

et al. 2018

JJECT

View full text Add to dashboard Cite

show abstract

“…Although guidelines are regularly updated, implementation and compliance remain poor [14]. Prolonged turnaround times for conventional coagulation tests, which are typically quoted at 60-90 min, are one of the major explanations for this variability, as many transfusions are based on clinical judgement, rather than on real-time information.…”

Section: Rationale For Using Poc Monitoringmentioning

confidence: 99%

Point‐of‐care monitoring of haemostasis

Mallett

Armstrong

2014

Anaesthesia

View full text Add to dashboard Cite

SummaryRecent research in the management of haemorrhage has led to several changes in clinical practice. Evidence is accumulating that point‐of‐care testing results in fewer transfusions, improved patient outcomes, and reduced hospital costs. However, there is still insufficient high quality evidence to support transfusion guidelines and algorithms based on point‐of‐care tests alone, and more robust studies are needed. The implementation of point‐of‐care testing requires institutional support and senior clinical leadership to realise the benefits, with educational programmes, audit, and feedback regarding transfusion practice. A change in philosophy is required, from performing testing only when there is an obvious bleeding problem, towards the concept of routinely monitoring high‐risk patients throughout the surgical procedure. This informs clinical practice, establishes normal ranges for that population, identifies patients at risk and allows early identification and treatment of evolving coagulopathy.

show abstract

“…Indeed, previous studies have shown that many physicians are unaware of guideline content in this important area and may lack the scientific basis to make a valid risk-versus-benefit assessment. 1 In our current era of shared decision making and patient-centered care, it is vital that physicians counsel patients with accurate information. It behooves physicians, therefore, to acquire the necessary knowledge to address patient-specific risk during the informed consent process and to make their patients aware of all available alternative therapies.…”

Section: Commentmentioning

confidence: 99%

Perceptions About Blood Transfusion

Vetter

Adhami

Porterfield

et al. 2014

Survey of Anesthesiology

View full text Add to dashboard Cite

B lood transfusion is the main treatment for surgical blood loss.Patients and their physicians often evaluate transfusion in terms of the risk of adverse events. Their perceptions may alter the ability to obtain informed consent and the responsiveness to a patient's preferences, needs, and values. Because patient-centered care is the norm in current practice, clinicians must have an understanding of a patient's perceptions of transfusion practice and incorporate this knowledge into shared decision making. This survey study was performed to determine preoperative patients' perceptions of transfusion as associated with age, sex, race, education level, and blood donor status. The investigators also sought to determine whether the patients' perceptions differed from those of anesthesiologists and surgeons.The paper survey for the patients was essentially identical to the electronic survey for clinicians. They were questionnaires about knowledge and attitudes. Each survey asked about demographic information, perceptions of the overall risk of blood transfusions, level of concern about 5 known adverse events with blood transfusion, and perceptions of the frequency of these 5 adverse events, including allergic reaction, fever, dyspnea, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) or hepatitis, and medical error. No question was included in the patient survey regarding the risk of donating blood. A 5-point Likert scale was used to generate a transfusion-related risk score, adverse event concern, and adverse event frequency. Patients completed the survey during routine outpatient preoperative evaluation. Full-time faculty from the departments of anesthesiology and surgery were recruited. All patient and clinician responses were anonymous. Conventional inferential biostatistics were used, and a P < 0.05 indicated statistical significance.A total of 294 patients and 73 physicians completed the surveys. The patients had a mean age of 55 years; most were women. Most patients were white, with African Americans the most common minority. Among the patients, 24% had previously received a blood transfusion, and 95% said they would have one if recommended by their physician; only 18% were aware of alternatives to blood transfusion. Twenty percent of the patients (95% confidence interval [CI], 15%-25%) perceived blood transfusion as being either "very often risky" or "always risky." African American race and having a high school or less level of education were associated with greater perceived overall blood transfusion risk (P = 0.028 and 0.022, respectively). For adverse events, African American race (P = 0.001) and high school or less education (P = 0.009) were associated with a greater concern about allergic reaction, fever (P < 0.001; P = 0.039), and dyspnea (P = 0.001; P = 0.004). Having a high school or less level of education was associated with a greater concern about HIV/AIDS and hepatitis (P = 0.003) and medical error (P = 0.039). Of 64 recruited anesthesiologists and 89 recruited surgeons, 3...

show abstract

Effect of the Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery Clinical Practice Guidelines of the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists upon Clinical Practices

Abstract: Wide variation in clinical practices of cardiac surgery was reported. Little change in clinical practices was attributed to the Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists Guidelines.

Cited by 83 publications

References 23 publications

Study profile of the perfusion registry in Japan

Study profile of the perfusion registry in Japan

Point‐of‐care monitoring of haemostasis

Perceptions About Blood Transfusion

Contact Info

Product

Resources

About