Introduction
Cardiac surgical procedures account for 10% to 15% of the 15 million
units of red blood cells (RBCs) transfused in the United States
annually.1 More than 32% of patients undergoing
coronary artery bypass grafting (CABG) receive a
transfusion.1 Blood transfusions and re-exploration
for bleeding have been shown to increase mortality and major morbidity
after cardiac surgery.2-8 Despite the potential risks
from transfusions, prevalence of transfusions varies widely
nationwide.9 Transfusion guidelines set forth by the
Society of Thoracic Surgeons (STS) in 200710 and again
in 201111 have not resulted in substantially decreased
blood use in cardiac operations.1 The purpose of this
study was to assess a multifaceted blood conservation and transfusion
protocol developed and applied at a community hospital cardiac surgery
program.