Hematology and Transfusion

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Author(s): Zarah Antongiorgi (UCLA, USA)and Vadim Gudzenko (UCLA, USA)
Copyright: 2015
Pages: 25
Source title: Modern Concepts and Practices in Cardiothoracic Critical Care
Source Author(s)/Editor(s): Adam S. Evans (Icahn School of Medicine at Mount Sinai, USA), Gregory E. Kerr (Weill Cornell Medical College, USA), Insung Chung (Icahn School of Medicine at Mount Sinai, USA)and Robin Varghese (Icahn School of Medicine at Mount Sinai, USA)
DOI: 10.4018/978-1-4666-8603-8.ch020

Keywords: Cardiovascular Medicine / Medical Diagnosis and Practice / Medical Information Science Reference / Medicine & Healthcare

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Abstract

The cardiac perioperative period presents a unique clinical scenario where the risk of life-threatening hemorrhage is balanced against the risk of thrombosis. Management practices are in a continual flux as practitioners respond to evidence showing the serious harms independently associated with anemia, bleeding and transfusion of blood (Ranucci, Aronson, et al., 2011a). Despite comprehensive transfusion guideline recommendations rates of blood transfusion range from 7.8% to 92.8% across US hospitals (Bennett-Guerrero et al., 2010). In this chapter we navigate the complex hemostasis and transfusion issues in cardiac surgery to provide clinicians a comprehensive understanding of the coagulation system in this specialized population. We emphasize a multidisciplinary team approach focused on risk stratification with preoperative optimization to minimize coagulopathy and bleeding followed by a tailored and conservative use of blood products for maximum patient benefit.

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