2011 update to the society of thoracic surgeons and the society of cardiovascular anesthesiologists blood conservation clinical practice guidelines

Victor A. Ferraris, Jeremiah R. Brown, George J. Despotis, John W. Hammon, T. Brett Reece, Sibu P. Saha, Howard K. Song, Ellen R. Clough, Linda J. Shore-Lesserson, Lawrence T. Goodnough, C. David Mazer, Aryeh Shander, Mark Stafford-Smith, Jonathan Waters, Robert A. Baker, Timothy A. Dickinson, Daniel J. Fitzgerald, Donald S. Likosky, Kenneth G. Shann

Research output: Contribution to journalArticlepeer-review

988 Scopus citations

Abstract

Background: Practice guidelines reflect published literature. Because of the ever changing literature base, it is necessary to update and revise guideline recommendations from time to time. The Society of Thoracic Surgeons recommends review and possible update of previously published guidelines at least every three years. This summary is an update of the blood conservation guideline published in 2007. Methods The search methods used in the current version differ compared to the previously published guideline. Literature searches were conducted using standardized MeSH terms from the National Library of Medicine PUBMED database list of search terms. The following terms comprised the standard baseline search terms for all topics and were connected with the logical 'OR' connectorExtracorporeal circulation (MeSH number E04.292), cardiovascular surgical procedures (MeSH number E04.100), and vascular diseases (MeSH number C14.907). Use of these broad search terms allowed specific topics to be added to the search with the logical 'AND' connector. Results In this 2011 guideline update, areas of major revision include: 1) management of dual anti-platelet therapy before operation, 2) use of drugs that augment red blood cell volume or limit blood loss, 3) use of blood derivatives including fresh frozen plasma, Factor XIII, leukoreduced red blood cells, platelet plasmapheresis, recombinant Factor VII, antithrombin III, and Factor IX concentrates, 4) changes in management of blood salvage, 5) use of minimally invasive procedures to limit perioperative bleeding and blood transfusion, 6) recommendations for blood conservation related to extracorporeal membrane oxygenation and cardiopulmonary perfusion, 7) use of topical hemostatic agents, and 8) new insights into the value of team interventions in blood management. Conclusions Much has changed since the previously published 2007 STS blood management guidelines and this document contains new and revised recommendations.

Original languageEnglish
Pages (from-to)944-982
Number of pages39
JournalAnnals of Thoracic Surgery
Volume91
Issue number3
DOIs
StatePublished - Mar 2011

Bibliographical note

Funding Information:
Author Disclosure Lecture Fees, Consultant, Paid Work From Industry Within 12 Months Research Grant Support From Industry Within 12 Months V. A. Ferraris No None None S. P. Saha Yes Baxter J. Waters Yes Biotronics Sorin Group A. Shander Yes Bayer, Luitpold, Masimo, Novartis, NovoNordisk, OrthoBiotech, Zymogenetics Bayer, Novartis, NovoNordisk, Ortho Biotech, Pfizer, ZymoGenetics L. T. Goodnough Yes Eli Lilly, CSL Behring, Luitpold, Amgen L. J. Shore-Lesserson Yes CSL Behring, Novonordisk K. G. Shann No G. J. Despotis Yes Genzyme, CSL Behring, Zymogenetics, Bayer, Cubist, SCS Healthcare, Telacris, Eli Lilly, Medtronic, ROTEM, NovoNordisk, Biotrack, HemoTech, Genzyme/GTC J. R. Brown Yes None AHRQ K01HS018443 Acute Kidney Injury J. W. Hammon Yes Medtronic, St. Jude Medical C. D. Mazer Yes NovoNordisk, Oxygen Biotherapeutics, Cubist NovoNordisk, Cubist R. A. Baker Yes Terumo Cardiovascular; Lunar Innovations; Cellplex Pty Ltd, Somanetics D. S. Likosky Yes AHRQ, Maquet Cardiovascular, Somanetics Corporation; Sorin Biomedica; Terumo Cardiovascular Systems, Medtronic T. A. Dickinson Yes SpecialtyCare, Inc D. J. FitzGerald No H. K. Song Yes Novo Nordisk A/S T. B. Reece No M. Stafford-Smith Yes PolyMedix, Inc E. R. Clough No

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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