Blood Conservation During Heart Surgery Good for Patients, Local Blood Banks
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LEXINGTON, Ky. (May 16, 2007) − High-risk heart surgery often
requires a large amount of blood transfusion, and about 15 to 20 percent of those patients use
more than 80 percent of available blood products. But new blood conservation guidelines
developed by a team of medical experts led by UK HealthCare surgeon Dr.
Victor A. Ferraris aim to help physicians solve the blood dilemma while improving outcomes
for heart surgery patients at the same time.
The new clinical guidelines were published as a standalone supplement to the May 2007 issue of The Annals of Thoracic Surgery. Ferraris said these new guidelines represent a landmark undertaking with wide application and great significance. “This work should serve as a template for individual cardiothoracic surgeons and for institutions as they manage valuable and scarce blood component resources.”
Committees from the Society of Thoracic Surgeons and Society of Cardiovascular Anesthesiologists collaborated to determine the evidence-based series of recommendations. They reviewed all available published evidence related to blood conservation during heart operations and identified preoperative and perioperative interventions that are likely to reduce bleeding and postoperative blood transfusion.
Some evidence-based blood conservation techniques include drugs that increase preoperative blood volume or decrease post-operative bleeding; devices that conserve blood; and interventions that protect the patient’s own blood from the stress of operation.
The guidelines also include strong evidence that patients who receive more blood during heart surgery have more postoperative infection, more kidney failure and more lung dysfunction, further urging the need to reduce the amount of blood products used with those patients.
Dr. Bruce Spiess, a fellow committee member and an anesthesiologist at Virginia Commonwealth University Medical Center, said development of the guidelines is a huge event for medicine. "Blood must be viewed as a scarce resource that carries risks and benefits," he said. "If these guidelines are adopted by a majority of cardiovascular centers in the world, we can decrease the amount of blood transfusions, blood usage and cost, and blood shortages would be less frequent and not occur to such a degree.”
Ferraris is chief of the University of Kentucky College of Medicine Department of Surgery's Division of Cardiothoracic Surgery and the Tyler Gill Professor of Vascular Surgery. He also is co-director of UKHealthCare's Linda and Jack Gill Heart Institute.
The new clinical guidelines were published as a standalone supplement to the May 2007 issue of The Annals of Thoracic Surgery. Ferraris said these new guidelines represent a landmark undertaking with wide application and great significance. “This work should serve as a template for individual cardiothoracic surgeons and for institutions as they manage valuable and scarce blood component resources.”
Committees from the Society of Thoracic Surgeons and Society of Cardiovascular Anesthesiologists collaborated to determine the evidence-based series of recommendations. They reviewed all available published evidence related to blood conservation during heart operations and identified preoperative and perioperative interventions that are likely to reduce bleeding and postoperative blood transfusion.
Some evidence-based blood conservation techniques include drugs that increase preoperative blood volume or decrease post-operative bleeding; devices that conserve blood; and interventions that protect the patient’s own blood from the stress of operation.
The guidelines also include strong evidence that patients who receive more blood during heart surgery have more postoperative infection, more kidney failure and more lung dysfunction, further urging the need to reduce the amount of blood products used with those patients.
Dr. Bruce Spiess, a fellow committee member and an anesthesiologist at Virginia Commonwealth University Medical Center, said development of the guidelines is a huge event for medicine. "Blood must be viewed as a scarce resource that carries risks and benefits," he said. "If these guidelines are adopted by a majority of cardiovascular centers in the world, we can decrease the amount of blood transfusions, blood usage and cost, and blood shortages would be less frequent and not occur to such a degree.”
Ferraris is chief of the University of Kentucky College of Medicine Department of Surgery's Division of Cardiothoracic Surgery and the Tyler Gill Professor of Vascular Surgery. He also is co-director of UKHealthCare's Linda and Jack Gill Heart Institute.