@article{Budak_McCusker_Gunaydin_2017, title={A Cardiopulmonary Bypass Based Blood Management Strategy in Adult Cardiac Surgery}, volume={20}, url={https://journal.hsforum.com/index.php/HSF/article/view/1792}, DOI={10.1532/hsf.1792}, abstractNote={<p class="p1"><span class="s1"><strong>Background:</strong> Despite the recent introduction of a number of technical and pharmacologic blood conservation measures, bleeding and allogeneic transfusion remain persistent problems in open-heart surgical procedures. Efforts should be made to decrease or completely avoid transfusions to avoid these negative reactions.</span></p><p class="p1"><span class="s1"><strong>Methods:</strong> </span>Our coronary artery bypass grafting database was reviewed retrospectively and a total of 243 patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) were studied in a 12-month period (January-December 2016) after the implementation of the new program, and compared with 275 patients of the previous 12-month period.</p><p class="p1"><span class="s1">All the staff involved in the care of the patients were educated about the risks and benefits of blood transfusions and the new transfusion guidelines in a 45-min training. We revised our guidelines for transfusions based on the STS. A transfusion log was created. Reduction in IV fluid volume was targeted. CPB circuitry was redesigned to achieve significantly less prime volume.<span class="Apple-converted-space"> </span></span></p><p class="p1"><span class="s1"><strong>Results:</strong> The proportion of patients transfused with red blood cells was 56% (n =154) in the control group and reduced by 26.8% in the study group (29.2%; 71 patients; <br /> <em>P</em> &lt; .01). Blood transfusion rate (1.7 ± 1/3.05 ± 1 units), postoperative hemorrhage (545 ± 50/ 775 ± 55 mL), respiratory support duration (12.4 ± 7/16.8 ± 8 h) and ICU stay (2.2±1.1/ 3.5±1.2 days) were significantly better in the blood conservation group. <span class="Apple-converted-space"> </span></span></p><p class="p1"><span class="s2"><strong>Conclusion:</strong> These findings, in addition to risks and side effects of blood transfusion and the rising cost of safer blood products, justify blood conservation in adult cardiac operations.<span class="Apple-converted-space"> </span></span></p>}, number={5}, journal={The Heart Surgery Forum}, author={Budak, Ali Baran and McCusker, Kevin and Gunaydin, Serdar}, year={2017}, month={Oct.}, pages={E195-E198} }