Patient Blood Management in Cardiac Surgery

Team Approach.- Identification of patients at high risk for bleeding.- Definition and Risk Factors of Bleeding.- Relevance of Blood Loss and Economic Impact.- Preoperative measures to reduce anemia.- Risk of Anemia.- Therapy of Anemia.- Perioperative drug management to prevent bleeding and thrombosis.- Antiplatelet Drug Management.- Preoperative Management of Anticoagulants.- Bridging.- Monitoring of coagulation and hemostasis.- Platelet Function Monitoring.- Coagulation Monitoring.- Intraoperative measures to reduce bleeding and maintain hemostasis.- Anticoagulant Management.- Fibrinolysis.- Cardiopulmonary Bypass.- Blood Conservation Strategies.- Minimally Invasive Extracorporeal Circulation Systems.- Volume Replacement.- The Jehovah's Witness.- Postoperative treatment of coagulopathy and microvascular bleeding.- Treatment Algorithms for Bleeding.- Treatment with Procoagulants.- Transfusion Thresholds for Packed Red Blood Cells.- Bleeding Management in the Intensive Care Unit.- Venous Thromboembolism Prophylaxis

This book provides a multidisciplinary approach to the maintenance of hemostasis and minimisation of blood loss in patients undergoing cardiac surgery. All aspects of patient blood management are covered that may contribute to a reduction in perioperative bleeding and transfusion requirements in cardiac surgery. This is achieved through practical cases and a theoretical background that gives a better understanding of patient hemostasis and the occurrence of bleeding complications.

This book is relevant to cardiac surgeons, anesthesiologists, clinical perfusionists, hematologists and intensivists.

Christian von Heymann is a Professor of Anesthesiology and Intensive Care Medicine appointed at the Charite - Medical Faculty of the Humboldt-University of Berlin and is head of the Department of Anesthesia, Intensive Care and Emergency Medicine and Pain Therapy at the Vivantes Klinikum im Friedrichshain, a large tertiary care and teaching hospital, in the center of Berlin, Germany. His main research interests are preoperative anemia, clotting and bleeding disorders in cardiac, general surgery and intensive care medicine. Dr. von Heymann has co-authored the EACTA/EACTS guideline on Patient Blood Management in Cardiac Surgery as well as the German guidelines on Preoperative Anemia and the Diagnostics and Treatment of Peripartum Hemorrhage. He is a member of several committees on Transfusion and Blood Conservation at the German Medical Chamber, the EACTA subcommittee of Hemostasis and Transfusion, and currently chairs the Transfusion, Hemostasis and Thrombosis subcommittee of the ESA.

Christa Boer is Professor of Anesthesiology, Research in Perioperative Care, in Amsterdam UMC (VU University) and Director of the VUmc School of Medical Sciences. She is member of the editorial board of the British Journal of Anaesthesia. Her translational research focuses on the interplay between microcirculatory perfusion, endothelial activation and coagulation during cardiopulmonary bypass and hemorrhagic shock and on postoperative care. She is member of the subcommittee Transfusion, Hemostasis and Thrombosis of the ESA, and past chair of the subcommittee Hemostasis and Transfusion of EACTA. Dr. Boer co-chaired the recently published EACTS-EACTA guideline Patient Blood Management in Cardiac Surgery. In addition, she was member of the SCA Blood Conservation workgroup and NATA scientific committee.