• Jeremie Czarnecka, Arthur Neuschwander, Thomas Aujoulat, Adrien Balmier, Dominique Belcour, Boris Boulanger, Caroline Bourgain, Margot Caron, Gabor Kiss, Mathilde Larghi, Christophe Lebard, Vincent Mellano, Jonathan Larson, Blandine Megroian, Anaelle Lefrançois, Sylvain Fox, Arnaud Pollet, Pierre Bourgoin, Guillaume Biland, Eric Braunberger, Guillaume Maccio, and Benjamin Delmas.
• Department of Anaesthesia and Critical Care for Cardiovascular and Thoracic Surgery, Felix Guyon University Hospital, Saint-Denis, Reunion, France.
• J. Cardiothorac. Vasc. Anesth. 2024 Jan 1; 38 (1): 737973-79.

ObjectivesAnemia and transfusion are common in cardiac surgery patients, and are associated with significant morbidity and mortality. Multiple perioperative interventions have been described to reduce blood transfusion, but are rarely combined altogether. The aim of this study was to compare the incidence of red blood cell (RBC) transfusion in adult patients undergoing cardiac surgery before and after the implementation of a perioperative patient blood management (PBM) program.DesignBefore-and-after observational study.SettingSingle-center French university teaching hospital.ParticipantsAdult patients scheduled for cardiac surgery.InterventionsPerioperative patient blood management program including pre-, intra-, and postoperative interventions aimed at identifying and correcting anemia, minimizing blood loss during surgery, and optimizing coagulation.Measurements And Main ResultsFour hundred thirty-four patients were included in the study from January 2021 to July 2022. The incidence of perioperative RBC transfusion (intraoperatively and during the first 2 postoperative days) was significantly reduced from 43% (90/213) in the pre-PBM period to 27% (60/221) in the post-PBM period (p < 0.001). The application of a PBM program was associated with a reduction in perioperative RBC transfusion by multivariate analysis (odds ratio 0.55, 95% CI 0.36-0.85, p = 0.007), and was associated with a reduction in the median number of RBC units transfused within transfused patients (p = 0.025). These effects persisted at day 30 after surgery (p = 0.029).ConclusionA perioperative PBM program in adult patients undergoing cardiac surgery was associated with a significant reduction in perioperative RBC transfusion, which persisted at day 30.Copyright © 2023 Elsevier Inc. All rights reserved.

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