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Blood management 

Blood management
Chapter:
Blood management
Author(s):

Gavin J. Murphy

, Nishith N. Patel

, and Nicola Curry

DOI:
10.1093/med/9780199653478.003.0018
Page of

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date: 21 October 2019

Bleeding is an important feature of cardiac surgery that may result in profound blood loss requiring large volume transfusion of red blood cells (RBC) and other blood components. However, transfusion of RBC may cause adverse effects and the degree of anaemia that should trigger their transfusion remains controversial. Coagulopathy that may arise from preoperative treatment with anti-thrombotic drugs and intraoperative events, exacerbates surgical causes of bleeding. Blood products including platelet concentrate and fresh frozen plasma have traditionally been used to treat coagulopathy. More recently, prothrombin complex fibrinogen concentrates have also been used. Mechanical and pharmaceutical approaches are used to reduce blood loss and transfusion. Finally, the place of transfusion risk scores in an integrated approach to blood management is discussed.

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