Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients.

Abstract:

:Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research has revealed that adherence to these guidelines is poor, and as a result, a significant variability in patient transfusion practices among practitioners still remains. In addition, although utilization of point of care coagulation monitors and the use of novel therapeutic strategies for perioperative hemostasis, such as the use of coagulation factor concentrates, has increased significantly over the last decade, they are still not widely available in every institution. Therefore, despite continuous efforts, blood transfusion in cardiac surgery has declined only modestly over the last decade, remaining at 50% or greater in high-risk patients. Given these limitations and in response to new regulatory and legislature requirements, the Society of Cardiovascular Anesthesiologists has formed the Blood Conservation in Cardiac Surgery Working Group in order to organize, summarize, and disseminate the available best-practice knowledge in patient blood management in cardiac surgery. The current publication includes the summary statements and algorithms designed by the working group, after collection and review of the existing guidelines, consensus statements, and recommendations for patient blood management practices in cardiac surgery patients. The overall goal is creating a dynamic resource of easily accessible educational material that will help to increase and improve compliance with the existing evidence-based best practices of patient blood management by cardiac surgery care teams.

authors

Raphael J,Mazer CD,Subramani S,Schroeder A,Abdalla M,Ferreira R,Roman PE,Patel N,Welsby I,Greilich PE,Harvey R,Ranucci M,Heller LB,Boer C,Wilkey A,Hill SE,Nuttall GA,Palvadi RR,Patel PA,Wilkey B,Gaitan B,Hill SS

doi

10.1053/j.jvca.2019.04.003

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

2887-2899

issue

11

eissn

1053-0770

issn

1532-8422

pii

S1053-0770(19)30350-7

journal_volume

33

pub_type

杂志文章,评审
  • Optimal Position of Inferior Vena Cava Cannula in Pediatric Cardiac Surgery: A Prospective, Randomized, Controlled, Double-Blind Study.

    abstract:OBJECTIVE:To examine the authors' hypothesis that during the cardiopulmonary bypass (CPB) in children, the inferior vena cava cannula tip placed proximal to the right hepatic vein orifice would produce a higher venous drainage compared with that placed distally. DESIGN:A prospective, randomized, controlled, double-bli...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1053/j.jvca.2018.10.023

    authors: Seino Y,Ohashi N,Imai H,Baba H

    更新日期:2019-05-01 00:00:00

  • Type of anesthesia and postoperative delirium after vascular surgery.

    abstract:OBJECTIVE:The purpose of this study was to investigate the association between general (GA), regional (RA), and local (LA) anesthetic techniques with respect to the development of delirium after vascular surgery. The authors hypothesized that patients undergoing GA for vascular surgery would have a higher incidence of ...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1053/j.jvca.2013.12.003

    authors: Ellard L,Katznelson R,Wasowicz M,Ashworth A,Carroll J,Lindsay T,Djaiani G

    更新日期:2014-06-01 00:00:00

  • Technology: Is There Sufficient Evidence to Change Practice in Point-of-Care Management of Coagulopathy?

    abstract::Currently, hemostasis is one of the most widely researched topics in perioperative medicine. As investigators learn more about the complexity of coagulation, developing tests with the ability to rapidly monitor coagulation and guide targeted therapy is the key to optimizing hemostasis management. There is mounting evi...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章,评审

    doi:10.1053/j.jvca.2017.05.037

    authors: Fabbro M 2nd,Winkler AM,Levy JH

    更新日期:2017-10-01 00:00:00

  • Preoperative interpleural administration of sufentanil or bupivacaine reduces intraoperative intravenous sufentanil requirements during thoracotomy.

    abstract::The efficacy of interpleural administration of sufentanil, 50 micrograms, was compared with that of 150 mg of bupivacaine, 0.5%, with epinephrine, 5 micrograms/mL, or saline, in 30 patients (N = 10 in each group) undergoing lateral thoracotomy. Sufentanil, bupivacaine, or saline was administered interpleurally after i...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1016/1053-0770(93)90307-7

    authors: Haak-van der Lely F,van Kleef JW,Burm AG,Bovill JG

    更新日期:1993-10-01 00:00:00

  • Anesthesia for Lung Transplantation in Cystic Fibrosis: Retrospective Review from the Irish National Transplantation Centre.

    abstract::Cystic fibrosis (CF) is an autosomal recessive disorder affecting approximately 1 in 2,500 live births worldwide, with double this estimated frequency in Ireland. CF is characterized by a genetic defect of the CF transmembrane regulator protein, causing impairment of chloride ion transportation. This has multisystem c...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1053/j.jvca.2017.11.041

    authors: Lenihan M,Mullane D,Buggy D,Flood G,Griffin M

    更新日期:2018-10-01 00:00:00

  • Preoperative Invasive Hemodynamic Determinants of Survival Among Patients Undergoing Aortic or Mitral Valve Surgery.

    abstract:OBJECTIVES:To evaluate the association of preoperative invasive hemodynamic parameters with mortality in valvular heart surgery. DESIGN:Retrospective cohort study. SETTING:Single tertiary academic medical center. PARTICIPANTS:A total of 382 patients who underwent preoperative right and/or left heart catheterization ...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1053/j.jvca.2017.09.041

    authors: Zhuo DX,Bilchick KC,Mazimba S

    更新日期:2018-06-01 00:00:00

  • Blood salvage in cardiac surgery.

    abstract::The aim of this study was to evaluate blood salvage provided by an intraoperative blood recovery system (IBRS) and a mediastinal drainage blood recovery system (MBRS) during and after cardiac surgery. Sixty-six patients undergoing aortocoronary bypass surgery were randomly assigned to three groups of 22 patients each....

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/1053-0770(91)90119-e

    authors: Parrot D,Lançon JP,Merle JP,Rerolle A,Bernard A,Obadia JF,Caillard B

    更新日期:1991-10-01 00:00:00

  • The Clinical Competency Committee in Adult Cardiothoracic Anesthesiology-Perspectives From Program Directors Around the United States.

    abstract::The clinical competency committee offers a fellowship program a structured approach to assess the clinical performance of each trainee in a comprehensive fashion This special article examines the structure and function of this important committee in detail. Furthermore, the strategies for the optimal functioning of th...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1053/j.jvca.2019.01.001

    authors: Black S,Capdeville M,Augoustides JGT,Nelson EW,Patel PA,Feinman JW,Gordon EK,Lockman JL,Yanofsky SD

    更新日期:2019-07-01 00:00:00

  • Long-term outcome of patients with perioperative myocardial infarction as diagnosed by troponin I after routine surgical coronary artery revascularization.

    abstract:OBJECTIVE:Diagnosis of perioperative myocardial infarction (P-MI) after coronary artery bypass graft (CABG) surgery traditionally relied on a combination of electrocardiographic and enzyme assay changes. Patients with Q-wave P-MIs who survive to hospital discharge have a poorer long-term prognosis. Troponin assays are ...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1053/j.jvca.2006.01.015

    authors: Riedel BJ,Grattan A,Martin CB,Gal J,Shaw AD,Royston D

    更新日期:2006-12-01 00:00:00

  • Propofol-fentanyl versus isoflurane-fentanyl anesthesia for coronary artery bypass grafting: effect on myocardial contractility and peripheral hemodynamics.

    abstract::To avoid intraoperative awareness and postoperative respiratory depression from high-dose opioid anesthesia, propofol (P), or isoflurane (I) has been combined with moderate-dose opioid with varying results. However, the effects of both P and I on myocardial contractility and left ventricular afterload have not been co...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s1053-0770(05)80050-3

    authors: Sorbara C,Pittarello D,Rizzoli G,Pasini L,Armellin G,Bonato R,Giron GP

    更新日期:1995-02-01 00:00:00

  • Computed tomography-based tracheobronchial image reconstruction allows selection of the individually appropriate double-lumen tube size.

    abstract:OBJECTIVES:To determine whether individualized selection of double-lumen tubes or alternatives based on three-dimensional reconstruction of the tracheobronchial image from routine preoperative computed tomography (CT) scans leads to clinically appropriate choices. DESIGN:Prospective observational study; comparison to ...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1016/s1053-0770(99)90003-4

    authors: Eberle B,Weiler N,Vogel N,Kauczor HU,Heinrichs W

    更新日期:1999-10-01 00:00:00

  • Comparison of tidal ventilation and high-frequency jet ventilation before and after cardiopulmonary bypass in dogs using two-dimensional transesophageal echocardiography.

    abstract::This study compared the use of high-frequency jet ventilation (HFJV) and tidal ventilation (TV) in a group of dogs with induced global myocardial ischemia before and after cardiopulmonary bypass. Transesophageal echocardiography was used to determine whether HFJV with its lower airway pressures could improve cardiac p...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1016/1053-0770(91)90153-k

    authors: Hayes JK,Smith KW,Port JD,Jordan WS

    更新日期:1991-08-01 00:00:00

  • Intraoperative Transesophageal Echocardiography for the Evaluation and Management of Diastolic Dysfunction in Patients Undergoing Cardiac Surgery: A Survey of Current Practice.

    abstract:OBJECTIVES:To characterize existing practice patterns for intraoperative evaluation and grading of diastolic dysfunction in patients undergoing cardiac surgery. DESIGN:A 14-question, multiple-choice survey of current practice for patients with diastolic dysfunction and the use of intraoperative transesophageal echocar...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1053/j.jvca.2015.11.002

    authors: McIlroy DR,Lin E,Hastings S,Durkin C

    更新日期:2016-04-01 00:00:00

  • Reducing mortality in cardiac surgery with levosimendan: a meta-analysis of randomized controlled trials.

    abstract:OBJECTIVES:The authors performed a meta-analysis to evaluate whether levosimendan is associated with improved survival in patients undergoing cardiac surgery. DESIGN:A meta-analysis. SETTING:Hospitals. PARTICIPANTS:A total of 440 patients from 10 randomized controlled studies were included in the analysis. INTERVEN...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章,meta分析,评审

    doi:10.1053/j.jvca.2009.05.031

    authors: Landoni G,Mizzi A,Biondi-Zoccai G,Bruno G,Bignami E,Corno L,Zambon M,Gerli C,Zangrillo A

    更新日期:2010-02-01 00:00:00

  • The effect of three different doses of tranexamic acid on blood loss after cardiac surgery with mild systemic hypothermia (32 degrees C).

    abstract:OBJECTIVE:Prophylactic administration of tranexamic acid (TA), an antifibrinolytic agent, decreases bleeding after cardiac surgery with systemic hypothermia (25 degrees C to 29 degrees C). Warmer systemic temperatures during cardiopulmonary bypass (CPB) may reduce bleeding and thus alter the requirement for TA. The eff...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s1053-0770(98)90235-x

    authors: Karski JM,Dowd NP,Joiner R,Carroll J,Peniston C,Bailey K,Glynn MF,Teasdale SJ,Cheng DC

    更新日期:1998-12-01 00:00:00

  • Nitric oxide synthesis inhibition and right ventricular systolic function in swine.

    abstract:OBJECTIVES:The present study was designed to evaluate the effects of the nitric oxide synthesis inhibitor NG-nitro-L-arginine methyl ester (L-NAME) on right ventricular (RV) contractility, both pulsatile and nonpulsatile contributions to afterload, and relate any changes to alterations in performance of the RV as a pum...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1016/s1053-0770(96)80055-3

    authors: Heerdt PM,Pleimann BE

    更新日期:1996-12-01 00:00:00

  • Multiple Electrode Aggregometry After Cardiopulmonary Bypass to Assess Platelet (Dys)-Function and Transfusion Threshold: A Concordance Study.

    abstract:OBJECTIVE:Cardiac surgery patients have a high risk of postoperative bleeding. Historically, the platelet count has been one of the main parameters used to establish the need for platelet transfusions, and the recent introduction of point-of-care tests for platelet function has allowed clinicians to rationalize platele...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1053/j.jvca.2020.06.060

    authors: Auci E,Vetrugno L,Riccardi I,Brussa A,Orso D,Baroselli A,Gigante A,Cecotti R,Bassi F,Livi U,Bove T

    更新日期:2020-12-01 00:00:00

  • Prone positioning and acute respiratory distress syndrome after cardiac surgery: a feasibility study.

    abstract:OBJECTIVE:To determine the feasibility, safety, and efficacy on PaO(2)/F(I)O(2) ratio of prone positioning (PP) for acute respiratory distress syndrome (ARDS) after cardiac surgery. DESIGN:Retrospective review of information entered prospectively in the authors' database. SETTING:A private community nonteaching hospi...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1053/j.jvca.2007.10.013

    authors: Maillet JM,Thierry S,Brodaty D

    更新日期:2008-06-01 00:00:00

  • Enalaprilat decreases plasma endothelin and atrial natriuretic peptide levels and preload in patients with left ventricular dysfunction after cardiac surgery.

    abstract:OBJECTIVE:To study the acute effects of angiotensin-converting enzyme inhibition by intravenous enalaprilat infusion in patients with left ventricular dysfunction after cardiac surgery. DESIGN:Prospective, consecutive sample, before-after trial. SETTING:Surgical intensive care unit in a tertiary care university hospi...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1016/s1053-0770(97)90009-4

    authors: Tohmo H,Karanko M,Klossner J,Scheinin M,Viinamäki O,Neuvonen P,Ruskoaho H

    更新日期:1997-08-01 00:00:00

  • Cardiac interventions in pregnancy and peripartum - a narrative review of the literature.

    abstract::In the UK, mortality rate during pregnancy/in the peripartal period is 14.1 per 100,000 maternities with heart disease being the leading cause of non-obstetric maternal mortality (10% to 15% of all maternal deaths). Owing to the advances in the treatment of congenital heart disease (CHD), an increasing percentage of w...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章,评审

    doi:10.1053/j.jvca.2019.12.021

    authors: Carlier L,Devroe S,Budts W,Van Calsteren K,Rega F,Van de Velde M,Rex S

    更新日期:2020-12-01 00:00:00

  • The clinical relevance of systolic pressure variations in anesthetized nonhypotensive patients.

    abstract:OBJECTIVE:To assess the accuracy of respiratory-induced systolic pressure variation and its components to detect low left ventricular preload. DESIGN:Prospective study. SETTING:University hospital. PARTICIPANTS:Sixty-seven patients undergoing major surgery under general anesthesia. INTERVENTIONS:Transesophageal ech...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1053/jcan.2003.45

    authors: Dalibon N,Guenoun T,Journois D,Frappier J,Safran D,Fischler M

    更新日期:2003-04-01 00:00:00

  • Increased alveolar damage after mechanical ventilation in a porcine model of thoracic surgery.

    abstract:OBJECTIVE:Mechanical stress during one-lung ventilation (OLV) results in lung injury. This study compared the effects of mechanical ventilation, OLV, and surgical manipulation on diffuse alveolar damage (DAD) after application of different anesthetic regimens. DESIGN:Prospective, randomized, controlled, blinded animal...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1053/j.jvca.2009.09.016

    authors: Kozian A,Schilling T,Röcken C,Breitling C,Hachenberg T,Hedenstierna G

    更新日期:2010-08-01 00:00:00

  • Central Extracorporeal Membrane Oxygenation for Bridging of Right-Sided Heart Failure to Lung Transplantation: A Single-Center Experience and Literature Review.

    abstract:OBJECTIVE:Right-sided heart failure develops in lung transplantation candidates on prolonged peripheral extracorporeal membrane oxygenation support and is a major determinant of mortality. The use of central venoarterial extracorporeal membrane oxygenation for bridging of right-sided heart failure to lung transplantati...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章,评审

    doi:10.1053/j.jvca.2019.01.059

    authors: Nam KH,Koh Y,Lim CM,Huh JW,Jung SH,Kang PJ,Lim JY,Hong SB

    更新日期:2019-07-01 00:00:00

  • Incidence and significance of abnormal hepatic venous Doppler flow velocities before cardiac surgery.

    abstract:OBJECTIVE:The purpose of this study was to determine the incidence and significance of abnormal hepatic Doppler venous flow velocities as signs of an abnormal right ventricular filling pattern before cardiac surgery. DESIGN:Retrospective and prospective validation study. SETTING:Tertiary care hospital. PARTICIPANTS:...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1053/j.jvca.2004.11.052

    authors: Carricart M,Denault AY,Couture P,Limoges P,Babin D,Levesque S,Fortier A,Pellerin M,Tardif JC,Buithieu J

    更新日期:2005-12-01 00:00:00

  • Anesthesia for percutaneous transcatheter closure of perimembranous ventricular septal defect.

    abstract:OBJECTIVE:To review the anesthetic management for percutaneous transcatheter closure of perimembranous ventricular septal defect (VSD) with an Amplatzer asymmetric occluder device and to highlight the hemodynamic effects and potential complications associated with its delivery. DESIGN:Retrospective review of prospecti...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1053/j.jvca.2005.05.023

    authors: Kapoor MC,Sharma S,Sharma VK,Dugal JS,Singh C

    更新日期:2006-04-01 00:00:00

  • A pump-prime aprotinin dose in cardiac surgery: appraisal of its effects on the hemostatic system.

    abstract:OBJECTIVES:To examine pump-prime aprotinin action on coagulation and fibrinolysis in patients undergoing primary coronary revascularization. DESIGN:A prospective randomized study. SETTING:A university hospital. PARTICIPANTS:Forty-three patients were randomly assigned to either group A, 21 patients treated with 2 x 1...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s1053-0770(97)90116-6

    authors: Rossi M,Storti S,Martinelli L,Varano C,Marra R,Zamparelli R,Possati G,Schiavello R

    更新日期:1997-12-01 00:00:00

  • Activated Coagulation Time and Hepcon Protamine Titration Device to Manage Unfractionated Heparin During Cardiopulmonary Bypass in a Hemophilia A Patient on Emicizumab.

    abstract::In the perioperative management of patients with hemophilia A, emicizumab prevents the accurate measurement of common clotting assays, including the activated clotting time (ACT), which is essential for high-dose heparin monitoring during cardiopulmonary bypass surgery. The authors describe the successful perioperativ...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:10.1053/j.jvca.2020.08.058

    authors: Isaacs J,Welsby IJ,Schroder JN,Onwuemene OA

    更新日期:2020-08-27 00:00:00

  • Blood Transfusion and Outcome After Transfemoral Transcatheter Aortic Valve Replacement.

    abstract:OBJECTIVE:To investigate the prognostic impact of red blood cell (RBC) transfusion on the outcome after transfemoral transcatheter aortic valve replacement (TAVR). DESIGN:Nationwide, retrospective multicenter study. SETTING:Five University Hospitals. PARTICIPANTS:The nationwide FinnValve registry included data from ...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章,多中心研究

    doi:10.1053/j.jvca.2019.06.038

    authors: Maaranen P,Husso A,Tauriainen T,Lahtinen A,Valtola A,Ahvenvaara T,Virtanen M,Laakso T,Kinnunen EM,Dahlbacka S,Juvonen T,Mäkikallio T,Jalava MP,Jaakkola J,Airaksinen J,Vasankari T,Rosato S,Savontaus M,Laine M,Raivio

    更新日期:2019-11-01 00:00:00

  • Femoral artery pressures are more reliable than radial artery pressures on initiation of cardiopulmonary bypass.

    abstract:OBJECTIVE:To compare radial and femoral artery perfusion pressure during initiation and various stages of cardiopulmonary bypass (CPB). DESIGN:Prospective study. SETTING:The cardiac center of a tertiary referral teaching institute. PARTICIPANTS:Sixty consecutive patients of all ages undergoing a variety of cardiac o...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章

    doi:

    authors: Chauhan S,Saxena N,Mehrotra S,Rao BH,Sahu M

    更新日期:2000-06-01 00:00:00

  • Tricuspid Regurgitation in Congestive Heart Failure: Management Strategies and Analysis of Outcomes.

    abstract::Tricuspid regurgitation is a notable aspect of congestive heart failure and is linked with worse outcomes if untreated. Functional tricuspid regurgitation commonly is seen in patients with heart failure, particularly in patients presenting for surgical management, such as those for mechanical cardiac assist device imp...

    journal_title:Journal of cardiothoracic and vascular anesthesia

    pub_type: 杂志文章,评审

    doi:10.1053/j.jvca.2020.06.022

    authors: Ramsdell GC,Nelson JA,Pislaru SV,Ramakrishna H

    更新日期:2020-06-12 00:00:00