Thorac Cardiovasc Surg 2017; 65(S 01): S1-S110
DOI: 10.1055/s-0037-1598919
e-Poster Presentations
Sunday, February 12, 2017
DGTHG: e-Poster: Miscellaneous
Georg Thieme Verlag KG Stuttgart · New York

Prospective Real-World Evaluation of an Interdisciplinary Blood Management Protocol for Patients Undergoing Cardiac Surgery

H. Baumgarten
1   Cardiac Surgery, Kerckhoff Klinik, Bad Nauheim, Germany
,
J.J. Squiers
2   Baylor, Scott & White Research Institute, Dallas, United States
,
G. Filardo
3   Department of Epidemiology, Baylor, Scott & White Health, Dallas, United States
,
J.M. J.M. Di
4   Cardiac Surgery, The Heart Hospital Baylor Plano, Plano, United States
,
M. Mack
4   Cardiac Surgery, The Heart Hospital Baylor Plano, Plano, United States
› Author Affiliations
Further Information

Publication History

Publication Date:
03 February 2017 (online)

   All articles of this category

Objectives: The Society of Thoracic Surgeons clinical practice guidelines recommend establishing an interdisciplinary blood management team to implement a blood management protocol with the goal of improving transfusion practices by properly balancing the risks and benefits. Here, we present data on the effectiveness of the blood management protocols we developed and implemented at our center.

Methods: An interdisciplinary blood management team developed protocols for transfusion of packed red blood cells, fresh frozen plasma, platelets, and cryoprecipitate. The protocols were prospectively evaluated and were then implemented in two phases during which protocol compliance was also assessed. Protocol implementation phases were separated by washout phases to control for a potential Hawthorne effect associated with protocol implementation.

Results: A total of 1,441 patients underwent cardiac surgery during the study period. There was a significant trend toward reduction of mean adjusted total units transfused per patient over the course of the study period (p < 0.001). The mean adjusted total units transfused per patient were significantly lower during the second washout phase (2.8 units,95% CI: 2.26–2.35) and second protocol phase (2.8 units,95% CI: 2.32–3.27) as compared with the initial baseline survey phase (3.6 units, 95% CI: 3.1–4.1, p < 0.05 for both comparisons). Only 55.2% of all units were transfused in compliance to the implemented protocols. Platelets (46.8%) and cryoprecipitate (32.1%) were less likely to be given in protocol compliance than packed red blood cells(60.7%) and fresh frozen plasma(53.6%).

Conclusion: The implementation of blood management protocols resulted in a significant reduction in the mean total units transfused per patient despite poor protocol compliance.