Bloodless Cardiac Surgery: Not Just Possible, But Preferable

@article{Putney2007BloodlessCS,
  title={Bloodless Cardiac Surgery: Not Just Possible, But Preferable},
  author={Leeann J Putney},
  journal={Critical Care Nursing Quarterly},
  year={2007},
  volume={30},
  pages={263–270}
}
  • Leeann J Putney
  • Published 1 July 2007
  • Medicine
  • Critical Care Nursing Quarterly
Blood transfusions after cardiac surgery are very common, and the rates are highly variable among institutions. Transfusion carries the risk of infectious and noninfectious hazards and is often clinically unnecessary. This article discusses the history of bloodless cardiac surgery, the hazards of transfusion, the benefits of reducing or eliminating transfusion, and strategies to conserve blood. It also provides a list of resources for those who are interested in learning more about bloodless… 
Transfusion-free anesthetic management for open heart surgery in a neonate -A case report-
TLDR
In a case of bloodless cardiac surgery in a 2.89 kg neonate with Jehovah's Witness parents, techniques for minimizing blood loss were used and blood sampling was minimized.
Transfusion associated in-hospital mortality and morbidity in isolated Coronary Artery Bypass Graft surgery
TLDR
It is concluded that the isolated CABG patients receiving blood transfusion have significantly higher mortality, morbidity and resource utilization.
Multidisciplinary strategies in bloodless medicine and surgery for patients undergoing pancreatectomy.
Effects of restrictive red blood cell transfusion on the prognoses of adult patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials
TLDR
It is demonstrated that the restrictive red blood cell transfusion strategy was not inferior to the liberal strategy with respect to 30-day mortality, pulmonary morbidity, postoperative infection, cerebrovascular accidents, acute kidney injury, or acute myocardial infarction, and fewer red blood cells were transfused.
Preventing deep wound infection after coronary artery bypass grafting: a review.
TLDR
It is recommended that cardiac surgery programs supplement their audit processes and ongoing vigilance for infections with periodic, multidisciplinary reviews of best-practice standards for preoperative, intraoperative, and postoperative patient care.
Preparing a Jehovah’s Witness for major elective surgery
TLDR
A 75 year old woman who was scheduled to undergo elective right sided mastectomy and axillary node clearance was seen in the preoperative assessment clinic and underwent successful surgery without the use of blood products.
Are there morally relevant differences between hymen restoration and bloodless treatment for Jehovah’s Witnesses?
TLDR
Since there were not enough relevant differences to justify offering bloodless operations to Jehovah’s Witnesses but not offering hymen reconstruction due to honour-related norms, it is concluded that these two groups of patients should be treated equally.

References

SHOWING 1-10 OF 34 REFERENCES
Perioperative blood transfusions: indications and options.
TLDR
A reevaluation of the indications for and alternatives to transfusion of allogeneic blood was precipitated by transfusion-induced HIV, and pharmacologic measures to increase hemoglobin levels (erythropoietin) and to decrease blood loss at surgery are discussed.
Profitability of Medical Procedures without the Use of Transfusion Support.
TLDR
Results of this study indicate that, overall, the CM for a CBMS patient is profitable, in fact, 16% more profitable than the general hospital population, and the Net Margin—total revenue less all expenses—on a per-patient basis was 17% more favorable as well.
Nursing strategies to minimize blood loss associated with phlebotomy.
TLDR
Implementation of these strategies are needed for all critically ill patients because allogeneic blood transfusions carry infectious risk and because complications and chronic critical illness cannot be predicted reliably.
Cardiovascular surgery in Jehovah's Witnesses. Report of 542 operations without blood transfusion.
TLDR
A 20-year experience with a consecutive series of 542 Jehovah's Witness patients ranging in age from 1 day to 89 years who underwent operation finds that cardiovascular operations can be performed safely without blood transfusion.
Cost, quality, and risk: measuring and stopping the hidden costs of coronary artery bypass graft surgery.
  • T. Morgan
  • Medicine
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2005
TLDR
Blood conservation programs offer a solution to the multiple problems that surround blood use and reduce safety concerns, hospital spending, and the dependency of hospitals on the national blood supply and improve clinical outcomes and patient satisfaction.
Variability in Transfusion Practice for Coronary Artery Bypass Surgery Persists Despite National Consensus Guidelines: A 24‐Institution Study
TLDR
Significant variability in institutional transfusion practice was observed for allogeneic packed red blood cells (PRBCs) and hemostatic blood components and for patients at institutions with liberal rather than conservative transfusions practice.
Impact of allogenic packed red blood cell transfusion on nosocomial infection rates in the critically ill patient*
TLDR
Transfusion of packed red blood cells is associated with nosocomial infection and this association continues to exist when adjusted for probability of survival and age, and mortality rates and length of intensive care unit and hospital stay are significantly increased in transfused patients.
...
1
2
3
4
...