Patient Blood Management in cardiac surgery: impact of an individualized strategy optimized by Erythropoietin and ferric carboxymaltose associated with ScvO2

• Published in: Journal of cardiothoracic and vascular anesthesia 2023-10, Vol.37, p.31-32
• Main Authors: SAOUR, Marine, BLIN, Cinderella, BOURDOIS, Benjamin, AMICO, Mailis, PICOT, Marie Christine, GAUDARD, Philippe, COLSON, Pascal
• Format: Article
• Language: English
• ISSN: 1053-0770
• DOI: 10.1053/j.jvca.2023.08.069

Patient Blood Management (PBM) has been encouraged in cardiac surgery to prevent anemia- and transfusion-induced morbidity and mortality.(1) Preoperative anemia has an increasing prevalence due to an ageing population with more chronic diseases, and affects up to 20 to 40% of patients who are scheduled for cardiac surgery.(2) Preoperative anemia by its own is an independent factor of adverse outcome, but it is also an independent factor of allogenic red blood cell (RBC) transfusions, which are associated too with a higher mortality risk.(3) Therefore blood conservation strategy in cardiac surgery is aimed at reducing both risks. This was a single-center, prospective, comparative, open label randomized trial. All patients signed a written informed consent. This trial protocol was approved by the local ethics committee (Sud Mediterrannée V 19.04.02.61948) and the French National Agency of Security of Drugs (ANSM) and was registered online at ClinicalTrails.gov (NCT04141631). An independent trial safety committee monitored trial benefit/risk ratio and safety for the entire duration of the study. In the control group, postoperative RBC transfusion was performed if hemoglobin (Hb) 8g/dL two administrations of oxide ferric sucrose (Venofer®, Viforpharma) were performed. In the STOP group (Optimisation Transfusion Strategy), EPO and CMF were administered if Hb