Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients

Jacob Raphael, C. David Mazer, Sudhakar Subramani, Andrew Schroeder, Mohamed Abdalla, Renata Ferreira, Philip E. Roman, Nichlesh Patel, Ian Welsby, Philip E. Greilich, Reed Harvey, Marco Ranucci, Lori B. Heller, Christa Boer, Andrew Wilkey, Steven E. Hill, Gregory A. Nuttall, Raja R. Palvadi, Prakash A. Patel, Barbara Wilkey & 9 others Brantley Gaitan, Shanna S. Hill, Jenny Kwak, John Klick, Bruce A. Bollen, Linda Shore-Lesserson, James Abernathy, Nanette Schwann, W. Travis Lau

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research has revealed that adherence to these guidelines is poor, and as a result, a significant variability in patient transfusion practices among practitioners still remains. In addition, although utilization of point of care coagulation monitors and the use of novel therapeutic strategies for perioperative hemostasis, such as the use of coagulation factor concentrates, has increased significantly over the last decade, they are still not widely available in every institution. Therefore, despite continuous efforts, blood transfusion in cardiac surgery has declined only modestly over the last decade, remaining at 50% or greater in high-risk patients. Given these limitations and in response to new regulatory and legislature requirements, the Society of Cardiovascular Anesthesiologists has formed the Blood Conservation in Cardiac Surgery Working Group in order to organize, summarize, and disseminate the available best-practice knowledge in patient blood management in cardiac surgery. The current publication includes the summary statements and algorithms designed by the working group, after collection and review of the existing guidelines, consensus statements, and recommendations for patient blood management practices in cardiac surgery patients. The overall goal is creating a dynamic resource of easily accessible educational material that will help to increase and improve compliance with the existing evidence-based best practices of patient blood management by cardiac surgery care teams.

Original languageEnglish (US)
Pages (from-to)2887-2899
Number of pages13
JournalJournal of cardiothoracic and vascular anesthesia
Volume33
Issue number11
DOIs
StateAccepted/In press - Jan 1 2019

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Hemostasis
Thoracic Surgery
Hemorrhage
Practice Guidelines
Blood Transfusion
Point-of-Care Systems
Guidelines
Guideline Adherence
Blood Coagulation Factors
Evidence-Based Practice
Practice Management
Therapeutic Uses
Publications
Morbidity
Mortality
Research

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

Cite this

Raphael, Jacob ; Mazer, C. David ; Subramani, Sudhakar ; Schroeder, Andrew ; Abdalla, Mohamed ; Ferreira, Renata ; Roman, Philip E. ; Patel, Nichlesh ; Welsby, Ian ; Greilich, Philip E. ; Harvey, Reed ; Ranucci, Marco ; Heller, Lori B. ; Boer, Christa ; Wilkey, Andrew ; Hill, Steven E. ; Nuttall, Gregory A. ; Palvadi, Raja R. ; Patel, Prakash A. ; Wilkey, Barbara ; Gaitan, Brantley ; Hill, Shanna S. ; Kwak, Jenny ; Klick, John ; Bollen, Bruce A. ; Shore-Lesserson, Linda ; Abernathy, James ; Schwann, Nanette ; Lau, W. Travis. / Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients. In: Journal of cardiothoracic and vascular anesthesia. 2019 ; Vol. 33, No. 11. pp. 2887-2899.
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abstract = "Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research has revealed that adherence to these guidelines is poor, and as a result, a significant variability in patient transfusion practices among practitioners still remains. In addition, although utilization of point of care coagulation monitors and the use of novel therapeutic strategies for perioperative hemostasis, such as the use of coagulation factor concentrates, has increased significantly over the last decade, they are still not widely available in every institution. Therefore, despite continuous efforts, blood transfusion in cardiac surgery has declined only modestly over the last decade, remaining at 50{\%} or greater in high-risk patients. Given these limitations and in response to new regulatory and legislature requirements, the Society of Cardiovascular Anesthesiologists has formed the Blood Conservation in Cardiac Surgery Working Group in order to organize, summarize, and disseminate the available best-practice knowledge in patient blood management in cardiac surgery. The current publication includes the summary statements and algorithms designed by the working group, after collection and review of the existing guidelines, consensus statements, and recommendations for patient blood management practices in cardiac surgery patients. The overall goal is creating a dynamic resource of easily accessible educational material that will help to increase and improve compliance with the existing evidence-based best practices of patient blood management by cardiac surgery care teams.",
author = "Jacob Raphael and Mazer, {C. David} and Sudhakar Subramani and Andrew Schroeder and Mohamed Abdalla and Renata Ferreira and Roman, {Philip E.} and Nichlesh Patel and Ian Welsby and Greilich, {Philip E.} and Reed Harvey and Marco Ranucci and Heller, {Lori B.} and Christa Boer and Andrew Wilkey and Hill, {Steven E.} and Nuttall, {Gregory A.} and Palvadi, {Raja R.} and Patel, {Prakash A.} and Barbara Wilkey and Brantley Gaitan and Hill, {Shanna S.} and Jenny Kwak and John Klick and Bollen, {Bruce A.} and Linda Shore-Lesserson and James Abernathy and Nanette Schwann and Lau, {W. Travis}",
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Raphael, J, Mazer, CD, Subramani, S, Schroeder, A, Abdalla, M, Ferreira, R, Roman, PE, Patel, N, Welsby, I, Greilich, PE, Harvey, R, Ranucci, M, Heller, LB, Boer, C, Wilkey, A, Hill, SE, Nuttall, GA, Palvadi, RR, Patel, PA, Wilkey, B, Gaitan, B, Hill, SS, Kwak, J, Klick, J, Bollen, BA, Shore-Lesserson, L, Abernathy, J, Schwann, N & Lau, WT 2019, 'Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients', Journal of cardiothoracic and vascular anesthesia, vol. 33, no. 11, pp. 2887-2899. https://doi.org/10.1053/j.jvca.2019.04.003

Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients. / Raphael, Jacob; Mazer, C. David; Subramani, Sudhakar; Schroeder, Andrew; Abdalla, Mohamed; Ferreira, Renata; Roman, Philip E.; Patel, Nichlesh; Welsby, Ian; Greilich, Philip E.; Harvey, Reed; Ranucci, Marco; Heller, Lori B.; Boer, Christa; Wilkey, Andrew; Hill, Steven E.; Nuttall, Gregory A.; Palvadi, Raja R.; Patel, Prakash A.; Wilkey, Barbara; Gaitan, Brantley; Hill, Shanna S.; Kwak, Jenny; Klick, John; Bollen, Bruce A.; Shore-Lesserson, Linda; Abernathy, James; Schwann, Nanette; Lau, W. Travis.

In: Journal of cardiothoracic and vascular anesthesia, Vol. 33, No. 11, 01.11.2019, p. 2887-2899.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients

AU - Raphael, Jacob

AU - Mazer, C. David

AU - Subramani, Sudhakar

AU - Schroeder, Andrew

AU - Abdalla, Mohamed

AU - Ferreira, Renata

AU - Roman, Philip E.

AU - Patel, Nichlesh

AU - Welsby, Ian

AU - Greilich, Philip E.

AU - Harvey, Reed

AU - Ranucci, Marco

AU - Heller, Lori B.

AU - Boer, Christa

AU - Wilkey, Andrew

AU - Hill, Steven E.

AU - Nuttall, Gregory A.

AU - Palvadi, Raja R.

AU - Patel, Prakash A.

AU - Wilkey, Barbara

AU - Gaitan, Brantley

AU - Hill, Shanna S.

AU - Kwak, Jenny

AU - Klick, John

AU - Bollen, Bruce A.

AU - Shore-Lesserson, Linda

AU - Abernathy, James

AU - Schwann, Nanette

AU - Lau, W. Travis

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research has revealed that adherence to these guidelines is poor, and as a result, a significant variability in patient transfusion practices among practitioners still remains. In addition, although utilization of point of care coagulation monitors and the use of novel therapeutic strategies for perioperative hemostasis, such as the use of coagulation factor concentrates, has increased significantly over the last decade, they are still not widely available in every institution. Therefore, despite continuous efforts, blood transfusion in cardiac surgery has declined only modestly over the last decade, remaining at 50% or greater in high-risk patients. Given these limitations and in response to new regulatory and legislature requirements, the Society of Cardiovascular Anesthesiologists has formed the Blood Conservation in Cardiac Surgery Working Group in order to organize, summarize, and disseminate the available best-practice knowledge in patient blood management in cardiac surgery. The current publication includes the summary statements and algorithms designed by the working group, after collection and review of the existing guidelines, consensus statements, and recommendations for patient blood management practices in cardiac surgery patients. The overall goal is creating a dynamic resource of easily accessible educational material that will help to increase and improve compliance with the existing evidence-based best practices of patient blood management by cardiac surgery care teams.

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DO - 10.1053/j.jvca.2019.04.003

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