Heart Surgery and Transfusions

Every two seconds in the United States, someone needs blood. One-fifth of the nation’s entire blood supply is used during heart surgery. Blood transfusions are not only costly, but they can pose risks for patients. Now, some hospitals in the U.S. are significantly reducing transfusion rates during heart surgery.

Harriet White has a new aortic valve, a new lease on life and she’s feeling great, even though she just had open-heart surgery. “I’m thrilled that I didn’t need a transfusion. It’s just one more thing that can go wrong.” White told us.

The society of thoracic surgeons has issued new guidelines to help hospitals cut back on transfusions during aortic valve surgery. Measures include rationing IV fluids, controlling blood thinners and cell saving.

Dr. Robert Brooker, Chief of Cardiac Anesthesia at Memorial Regional Hospital in Hollywood, Florida stresses the importance of blood conservation. “If there’s some bleeding during surgery the blood is not sent to a sucker that’s discarded. It’s sent to a recycling-type device so you can have that blood re-infused later.” Dr. Brooker explained.

Memorial Regional Hospital is one of a number of hospitals in the U.S. using blood conservation measures. Memorial dramatically reduced the percentage of heart surgery patients getting transfusions, from 59 percent in 2006 to 19 percent in 2011. The benefits are significant.

“The people who get a blood transfusion generally do more poorly. They have a higher risk of death. They have a higher risk of infection.” Dr. Brooker told us.

As a result, Dr. Brooker says patients like Harriet White do better overall and blood can be saved for those who really need it.

In a recently published study on aortic valve replacement surgery and blood conservation, researchers found patients who had the surgery without transfusion were almost two times less likely to have a major complication.

BLOOD TRANSFUSIONS: A blood transfusion is when blood is transported through an IV into one’s blood vessels. This procedure is done to replace large amounts of blood that was lost from a body during a surgery or injury. Blood transfusions are fairly common and rarely have any complications. It is estimated that nearly 5 million Americans will undergo a blood transfusion each year. (Source: www.nhlbi.nih.gov)

TYPES: There are three primary types of blood transfusions.
Red Blood Cell Transfusions: Red blood cells carry oxygen from the lungs to all of the organs and tissues of the body. One reason for this type of transfusion is due to anemia, a condition in which the blood has a lower number of red blood cells than the normal count.

Platelet and Clotting Factor Transfusions: This type of transfusion is done to halt bleeding that you can’t see (internal bleeding) by working with the plasma to create clots.
Plasma Transfusions: Plasma transfusions are done when blood is not clotting the way it should for a patient who is bleeding. A plasma transfusion may also take place after a severe burn or organ infection. Liver failure is another common reason for plasma transfusions. (Source: www.nhlbi.nih.gov)

NEW FINDING: Hospitals are reducing the amount of blood transfusions during heart surgeries not only to save money but also to save lives. Patients who receive transfusions are at an increased risk of developing major health problems such as kidney failure, infection and lung dysfunction. Memorial Regional Hospital in Hollywood has been reducing the amount of transfusions since 2007 and has seen significant evidence to claim that blood conservation can help save lives. Between 2007 and 2011, deaths related to open-heart surgery, infections and strokes all saw a drop of half or more at Memorial Regional Hospital. In 2008, new guidelines were implemented that were recommended by a team formed by the Society of Thoracic Surgeons which urged blood to be viewed as a scarce resource. (Source: Nicole Brochu)

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