This narrative review highlights the transition from whole blood to specific component therapy for managing bleeding in extensive cardiovascular procedures like aortic aneurysm surgery.
Does not support practice change in aortic surgery bleeding; leaves open need for RCTs on component versus whole blood therapy.
Blood transfusion for extensive cardiovascular procedures differs from one center to another depending on the local donor supply and the regional philosophy of efficient utilization. Our initial experience was obtained with the exclusive use of whole blood, no other products being available. Some centers still rely heavily on this, or on modified whole blood. Others use a variable number of units of whole blood, followed by specific hemocomponents that may be limited in supply. Since 1976, we have used the specific component therapy approach to supply all patient needs, including those associated with cardiovascular surgery. Our success depends as much on surgical skill, teamwork, and excellent communication as on the rapid availability of an adequate supply of hemocomponents. When problems occur during or after operation, immediate consultation with the blood bank staff and the availability of excellent technical and consultative expertise in blood coagulation are invaluable in the rapid restoration of the jeopardized patient.
No takes yet. Share an insight, caveat, or question.
Marion M. Worthington (1980) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: