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eComment: Re: Multi-modality blood conservation strategy in open heart surgery: an audit

Bakoulev Scientific Center for Cardiovascular Surgery, Roublevskoye Sh. 135, 21552 Moscow, Russia

Multi-modality blood conservation strategy in open-heart surgery: an audit

The development of a multidisciplinary strategy for blood conservation in cardio-vascular surgery is a very important factor. It limits any allogenic transfusion and as a result decreases the risk of transfusion infections, immunologic reactions and provides economic benefits [1]. It is well known that inflammatory response appearing at allogenic transfusion during cardiopulmonary bypass leads to postoperative complications and is a risk factor for mortality and morbidity in cardiac surgery [2]. Elderly age, anemia or low weighting patients during urgent or repeated prolonged surgeries with hypothermia and hemodilution, using antithrombotic drugs, with innate or obtained coagulopathy form the most problematic group that uses the biggest part of blood products in cardiac surgery [3].

The authors made the retrospective audit of a non-severe group of patients in which the usage of allogenic blood could be and must be minimized (17.4%). The evidence base of the article with the usage of an institutional protocol and performed by a single surgical team does not give a reason to recommend some present benefits for wide application in severe patients in cardiac surgery. Only multicentre randomized studies, performed in a large number of severe patients will allow us to get reliable results that would give the possibility to create an up-to-date multifactor program of blood conservation in cardio-vascular surgery. Further researches in this direction are very important and promising.

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1. Reddy SM, Talwar S, Velayoudam D, Gharde P, Mallick V, Jha RK, Kumar L, Arkalgud SK. Multi-modality blood conservation strategy in open heart surgery: an audit. Interact CardioVasc Thorac Surg 2009;9:480– 483.[Abstract/Free Full Text]
2. Senay S, Toraman F, Gunaydin S, Kilercik M, Karabulut H, Alhan C. The impact of allogenic red cell transfusion and coated bypass circuit on the inflammatory response during cardiopulmonary bypass: a randomized study. Interact CardioVasc Thorac Surg 2009;8:93–99.[Abstract/Free Full Text]
3. Ferraris VA, Ferraris SP, Saha SP. Hessel EA 2nd, Haan CK, Royston BD, Bridges CR, Higgins RS, Despotis G, Brown JR, Spiess BD, Shore- Lesserson L, Stafford-Smith M, Mazer CD, Bennett-Guerrero E, Hill SE, Body S. Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists clinical practice guideline. Ann Thorac Surg 2007;83(5 Suppl):S27–S86.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Leo A. Bockeria Permission Requests Google Scholar Articles by Bockeria, L. A. Articles by Grigoryants, R. G. PubMed PubMed Citation Articles by Bockeria, L. A. Articles by Grigoryants, R. G. Related Collections Related Article