The Society of Thoracic Surgeons (STS) convened a multidisciplinary panel of experts, including members of the Society of Cardiovascular Anesthesiologists (SCA), the American Society of ExtraCorporeal Technology (AmSECT), and the Society for the Advancement of Blood Management (SABM) to review the latest data on patient blood management and update the 2011 update to The Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists Blood Conservation Clinical Practice Guidelines.

The update emphasised upon the importance of an evidence-based, multimodal, and multidisciplinary approach to encompass optimisation of outcomes in patients at high risk for transfusion along with conserving blood resources.

Highlights of the GuidelineUpdate:#

Current Recommendations for Patient Blood Management Based on Intervention Type – ACC/AHA Class I Level A*

Preoperative interventions

Preoperative identification of high-risk patients should be performed, and all available preoperative and perioperative measures of blood conservation should be undertaken in this group as they account for the majority of blood products transfused.

Blood products and derivatives

Antithrombin III concentrates are indicated to reduce plasma transfusion in patients with antithrombin-mediated heparin resistance immediately before cardiopulmonary bypass.

Blood salvage interventions

Routine use of red cell salvage using centrifugation is helpful for blood conservation in cardiac operations using CPB.

ACC/AHA: American College of Cardiology/American Heart Association; CPB: Cardiopulmonary bypass
#Only Class I, Level A recommendations have been mentioned here.
*Class I: Strong strength of recommendation where benefit>>>risk; Level A: High-quality evidence from more than 1 randomised controlled trial (RCT), meta-analyses of high-quality RCTs, one or more RCTs corroborated by high-quality registry studies.

Source:
Tibi P, McClure RS, Huang J, et al. STS/SCA/Am SECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management.
Ann Thorac Surg. 2021;S0003–4975(21)00556-7.

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