Preoperative anemia is associated with an important increase in transfusions of red blood
cells (RBC) compared to a non-anemic patient in cardiac and non cardiac surgery. Furthermore
transfusion is also an independent factor of morbi-mortality with notably an increase in the
infectious risk, immunological, an increase of the risk of cardiac decompensation,
respiratory decompensation Transfusion Related Acute Lung Injury (TRALI) or Transfusion
Associated Cardiac Overload (TACO), and an increase in mortality of 16%.
Management of perioperative transfusion is therefore a public health issue. Since 2010, the
World Health Organization (WHO) has been promoting a systematic approach to implement blood
management programs for the patient to optimize the use of resources and promote quality and
safety of care.
Improving the relevance of transfusion in cardiac surgery could be achieved by optimizing the
management of patients around 2 axis:
A:non-drug intervention : Review of Practices to Improve the Management of Perioperative RBC
Transfusion
B:drug intervention : Systematic correction of pre- and postoperative iron, vitamin
deficiencies and anemia
The aim of this program is to improve the relevance of transfusion in cardiac surgery and to
limit the morbidity and mortality induced by transfusion. This program is part of a global
project of pre, per and postoperative management of the patient undergoing cardiac surgery
programmed under extracorporeal circulation (ECC). It requires a multidisciplinary approach
between cardiologists, anesthesiologists and intensivists, perfusionists, cardiac surgeons
and paramedical teams to optimize the management of the patient.