Evidenced based blood transfusion as an integral indicator of quality in cardiac surgery

The purpose of this review was to describe current data on evidenced based strategy for blood transfusion in adult cardiac surgery. Searching for publications was conducted in May 2025 using the PubMed database, TRANSFUSION EVIDENCE LIBRARY, and eLibrary.RU for the last five years. The following keywords were used: patient blood management in cardiac surgery, transfusion-associated immunomodulation, restrictive and liberal transfusion strategy, blood transfusion. Duplicates were excluded manually. Additional searching was performed in references. The first stage of selection after screening of abstracts took into account clinical trials, meta-analyses, randomized controlled trials, reviews and regular reviews without language restrictions. At the second stage, assessment of full-text articles was carried out with analysis of models for predicting the risk of perioperative transfusion, effectiveness and safety of restrictive or liberal transfusion strategies in cardiac surgery, modern technologies for improving the quality of donated blood components. Final analysis included 48 publications. Evidence based blood transfusion characterizes the effectiveness of blood management system as an integral indicator of quality of care in cardiac surgery. Each transfusion should be reasonable. This entails a reasonable assessment of likelihood, appropriateness of appointment, as well as use of highly effective and safe components of allogeneic blood for a particular patient.