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- W2988379009 abstract "Patient blood management (PBM) is currently undergoing a triumphal march like no other treatment bundle in medicine. Hardly any issue of an anesthesia journal appears without an article dealing with at least one aspect of PBM, be it preoperative preparation, bleeding management, or transfusion triggers. However, it is not always easy for clinicians to summarize this clinical knowledge, and by that, to apply the individual measures to their own, specialized clinical practice. Although there are many written works worth reading concerning the entirety of the concept of PBM, the transfer of these general concepts and recommendations, in the field of anesthesiology, for specific patient populations has proven to be quite difficult. That’s the point at which the presented book Patient Blood Management in Cardiac Surgery can be tied in. It intends to describe the individual measures of PBM, especially with regard to cardiac surgery. In fact, some aspects of this field are unique in terms of anticoagulation, bleeding management, or transfusion triggers. As an example, patients undergoing cardiac surgery are often anemic, therefore are usually anticoagulated for a longer period of time, their coagulation system is endangered by the use of the heart-lung machine and extensive surgery, and their myocardial performance is limited, warranting higher than usual transfusion triggers. As a consequence, general recommendations for PBM might be less useful in this clinical setting. The editors of the book have managed to invite well-known authors from all over the world, whose expertise guarantees that each aspect of PBM in cardiac surgery is covered with the highest scientific quality. The 2 editors of this book themselves are authors of the European Association of Cardiothoracic Anaesthesiology (EACTA) PBM guideline for cardiac surgery, and therefore it is guaranteed that each aspect of the book is covered by the newest evidence in perfect alignment with the current guideline of one of the most relevant scientific societies in this field. Although this fact is generally a strength of this book, one might ask why such a book is necessary if the latest guideline provides all the needed information and in a more compact format. The answer to this is not simple; if you are looking for the most recent recommendations of how to approach PBM for cardiac procedures, the EACTA guideline may be the appropriate document to reference. But, if you are interested in a deeper discussion about specific topics and if you would like to know why a given recommendation has been formulated the way it has, the content of the book is more than useful. It is important to point out that aspects of PBM are discussed in a balanced matter throughout this text, whereas the same topic is written rather directly in the guideline. One example of this is the chapter about transfusion triggers, which really helps one to understand why the situation may be specific for cardiac surgery patients in contrast to other patient groups. The book is divided into 6 different chapters, starting with risk evaluation, measures to reduce anemia, drug management, monitoring of coagulation, and ending with measures to avoid blood loss and treat bleeding. The quality of tables and illustrations is high, although the book is rather text-intensive. What was unfamiliar to me when I read the book was the assembly of the chapters. Generally, PBM is depicted as a 3 pillar model (see, eg, Althoff et al1), and at the moment, several medical societies are working on a universally valid definition of PBM. However, for this book, this 3 pillar model plays an irrelevant role for both the structure of the chapters and for the structure of the concepts. To add to this, the definition of PBM is only given in the preface. This can be seen as an advantage or disadvantage of the book. In fact, this approach sets the focus on cardiac surgery and bleeding rather than on PBM, which might be felt as adequate as it relates to the common goal of the editors. If one is looking for a book focusing on PBM and relating the information to cardiac surgery, there might be some disappointment. In contrast, if one is looking for a book covering management of bleeding, anemic cardiac surgery patients by means of PBM, this could be a perfect fit. If you are working in cardiac surgery and need some of the latest evidence regarding PBM in your field in a balanced and complete representation, then I clearly recommend you read this book. If you are interested in the process of PBM in general, discussing some topics like economics, its implementation and giving you a broader view, you should choose alternatives. The main audience for this book is the group of consultants working in cardiac surgery. Jens Meier, MDDepartment for Anesthesiology and Critical CareKepler University ClinicKepler UniversityLinz, Austria[email protected]" @default.
- W2988379009 created "2019-11-22" @default.
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- W2988379009 date "2020-02-01" @default.
- W2988379009 modified "2023-10-18" @default.
- W2988379009 title "Patient Blood Management in Cardiac Surgery" @default.
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- W2988379009 doi "https://doi.org/10.1213/ane.0000000000004541" @default.
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