CARDIAC SURGERY is inherently complex and is associated with a high risk of perioperative
bleeding. As such, it is responsible for a disproportionate percentage of annual blood
product usage in the United States, accounting for approximately 10%-to-15% of total
blood transfusions and up to 50% of platelets annually transfused.
1
,2
The transfusion rate within cardiac surgery is highly variable and is dependent on
numerous factors, such as type of procedure, patient acuity, institutional norms/protocols,
and the use of cardiopulmonary bypass (CPB). Reports in the literature estimate that
50%-to-65% of all patients undergoing surgery with CPB will require a blood transfusion
in the perioperative period.
2
Key Words
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References
- Coagulation management strategies in cardiac surgery.Curr Anesth Reports. 2017; 7: 265-272
- Bleeding following deep hypothermia and circulatory arrest in children.Semin Cardiothorac Vasc Anesth. 2007; 11: 34-46
- Perioperative blood transfusion and blood conservation in cardiac surgery: The Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists clinical practice guideline.Ann Thorac Surg. 2007; 83: S27-S86
- Fresh frozen plasma for cardiovascular surgery.Cochrane Database Syst Rev. 2015; CD007614
- Early or late fresh frozen plasma administration in newborns and small infants undergoing cardiac surgery: The APPEAR randomized trial.Br J Anaesth. 2017; 118: 788-796
- Fresh frozen plasma in the pediatric pump prime: A prospective, randomized trial.Ann Thorac Surg. 2004; 77: 983-987
- Fresh frozen plasma versus crystalloid priming of cardiopulmonary bypass circuit in pediatric surgery: A randomized clinical trial.Anesthesiology. 2020; 132: 95-106
- Influence of intraoperative fluid volume on cardiopulmonary bypass hematocrit and blood transfusions in coronary artery bypass surgery.J Extra Corpor Technol. 2008; 40: 99-108
- A snapshot of coagulopathy after cardiopulmonary bypass.Clin Appl Thromb Hemost. 2016; 22: 505-511
- Perioperative management of the bleeding patient.Br J Anaesth. 2016; 117: iii18-iii30
- An exploratory cohort study comparing prothrombin complex concentrate and fresh frozen plasma for the treatment of coagulopathy after complex cardiac surgery.Anesth Analg. 2015; 121: 26-33
- Efficacy and safety of a 4-factor prothrombin complex concentrate in patients on vitamin K antagonists presenting with major bleeding: A randomized, plasma-controlled, phase IIIb study.Circulation. 2013; 128: 1234-1243
- Three-factor prothrombin complex concentrates for refractory bleeding after cardiovascular surgery within an algorithmic approach to haemostasis.Vox Sang. 2019; 114: 374-385
- Intracardiac thrombosis after emergent prothrombin complex concentrate administration for warfarin reversal.Anesthesiology. 2015; 123: 458
- Cost comparison of andexanet versus prothrombin complex concentrates for direct factor Xa inhibitor reversal after hemorrhage.J Thromb Thrombolysis. 2020; 49: 121-131
- Modeling the cost-effectiveness of prothrombin complex concentrate compared with fresh frozen plasma in emergency warfarin reversal in the United kingdom.Clin Ther. 2010; 32: 2478-2493
- Predictors of massive transfusion with thoracic aortic procedures involving deep hypothermic circulatory arrest.J Thorac Cardiovasc Surg. 2011; 41: 1283-1288
- Hypothermic circulatory arrest induced coagulopathy: Rotational thromboelastometry analysis.Gen Thorac Cardiovasc Surg. 2020; 68: 754-761
- Safety and efficacy of aprotinin and tranexamic acid in pulmonary endarterectomy surgery with hypothermia: Review of 200 patients.Ann Thorac Surg. 2010; 90: 1432-1436
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Published online: May 17, 2021
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