Sultan Ghazzay Alotaibi, Muneeb Ammar Alnouri, Rawaa Mahmoud Sulaiman, Abdulkhalek Abduljaleel, Ahmed Foad Bogari, Hani Nabeel Mufti,
Volume 16, Issue 2 (June 2024 2024)
Background: Heart diseases are typically treated with cardiac surgery, which often requires preoperative, intraoperative, and postoperative blood transfusion. However, blood transfusion is a risk factor for serious complications after cardiac surgery, including death. Patient Blood Management (PBM) programs were developed to mitigate the risks of blood transfusion by reducing its use in cardiac surgery.
Objective: This systematic review aims to study the currently published literature on PBM strategies that effectively reduce the rates of preoperative, intraoperative, and postoperative blood transfusion for cardiac surgery.
Methodology: This systematic review analyzed preoperative blood management strategies in cardiac surgery, focusing on studies published between 2018 and 2024 designed to reduce blood transfusion rates. The study utilized a modified 2022 protocol for systematic reviews and meta-analysis, grading evidence using a 2008 system, and selected 21 studies for a systematic review.
Results: The studies identified 12 PBM strategies, including iron therapy, Aminocaproic acid, Cardiopulmonary by-pass system, cell salvage, Perfusion Blood Collection, gel foam patches, Large-volume acute normovolemic hemodilution, Platelets Transfusion Therapy, Modified Ultrafiltration, TEM-based algorithms, and restrictive management of SVO2, which significantly reduced blood transfusion volumes and rates before, during, and after cardiac surgery.
Conclusion: The 12 PBM strategies identified are valuable additions to the current list, but further clinical evaluation is needed to improve their efficacy and safety in cardiac surgery.
