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Blood Conservation Strategies in Cardiac Surgery

  • David RoystonEmail author
Chapter
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Abstract

Preoperative anaemia and perioperative allogeneic blood transfusions are associated with worse outcomes after surgery. In addition, transfusions are a scarce and costly resource. As cardiac surgery accounts for a significant proportion of all blood products transfused, efforts should be made to decrease the risk of perioperative transfusion. A variety of blood conservation strategies are reported to decrease the risk of perioperative transfusions in cardiac surgery. Preoperative strategies focus on the detection and treatment of anaemia. Intraoperatively, antifibrinolytics should be considered for high-risk scenarios, whereas strategies should be adopted to avoid haemodilution on cardiopulmonary bypass. Cell salvage and point-of-care tests should also be a part of the routine care. Postoperatively, any unnecessary iatrogenic blood loss should be avoided. These three components or pillars are central to all patient blood management programs. This chapter will discuss these in turn with particular emphasis on cardiac surgical practice.

Keywords

Antifibrinolytics Aprotinin Erythropoiesis Patient blood management Thromboelastography Thromboelastometry 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Cardiothoracic Anaesthesia, Critical Care and Pain ManagementHarefield HospitalLondonUK

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