Perioperative Anemia Management as Part of PBM in Cardiac Surgery - A Narrative Updated Review.

Patrick Meybohm, Sabine Westphal, Hanne Berg Ravn, Marco Ranucci, Seema Agarwal, Suma Choorapoikayil, Donat R Spahn, Aamer B Ahmed, Bernd Froessler, Kai Zacharowski

Journal: Journal of cardiothoracic and vascular anesthesia 2021;34(4):1060-1073

PMID: 31399306

Full Text on Elsevier Science View on PubMed

Abstract

Anemia is common in patients with cardiac disease. Iron deficiency is the cause of anemia in about 80% of all cases. Preoperative anemia is associated with an increased morbidity and mortality in patients undergoing cardiac surgery. The risk of receiving red blood cell transfusions, which are potentially associated with severe side effects, is very high in these patients. Patient Blood Management (PBM) is a multidisciplinary approach to manage anemia, minimize unnecessary blood loss, and optimize transfusion therapy. PBM comprises 3 pillars: (1) detection and treatment of preoperative anemia, (2) reduction of perioperative blood loss, and (3) optimization of allogeneic blood therapy. The World Health Organization has urged all Member States to implement PBM. This narrative review focuses on pre-, intra-, and postoperative strategies to detect, prevent, and treat anemia as part of PBM in cardiac surgery.

Address: Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany. Electronic address: [email protected].; Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany.; Department of Cardiothoracic Anesthesia, Heart Centre, Rigshospitalet, Copenhagen, Denmark.; Department of Cardiothoracic Anesthesia and ICU, I.R.C.C.S. Policlinico San Donato Milan, Milan, Italy.; Department of Cardiac Anesthesia abs Critical Care, Manchester University Hospital, Manchester, United Kingdom.; Institute of Anesthesiology, University Hospital Zürich, Zürich, Switzerland.; Department of Anesthesia, Glenfield Hospital, University Hospitals of Leicester NHS Trust; Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.; Department of Anesthesia, Lyell McEwin Hospital & Discipline of Acute Care Medicine, University of Adelaide, Adelaide, Australia.

DOI: 10.1053/j.jvca.2019.06.047

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MeSH Terms: Anemia, Blood Transfusion, Cardiac Surgical Procedures, Erythrocyte Transfusion, Hemorrhage, Humans