Marco Picichè
San Bortolo Hospital, Italy
Title: Management of blood transfusion in cardiac surgery
Biography
Biography: Marco Picichè
Abstract
The policy of transfusion in cardiac surgery has changed dramatically over the last decade. After years of almost anarchic management, relying upon local experiences, the Society of Thoracic Surgeons and the Association of Cardiovascular Anesthesiologists have set precious guidelines for transfusion in Cardiac Surgery, in 2007 and in 2011. The history of transfusion is fascinating. Humans recognized over time that the loss of blood was associated with weakness and death. Older history of blood transfusion based on the traditional idea of blood being the ‘living force’ of the body. Mystical fascination with the properties of blood shows some remnants even today, manifesting itself via such terms as ‘hot blooded’, ‘bad blood’, ‘cold blood’. After centuries of almost absent evolution, a great step forward took place only in the 21st century, with the introduction of sterile methodologies (Pasteur, Semmelweiss), the discovery of the ABO blood group system (Landois and Landsteiner), and the development of practical anticoagulation. Nowadays, evidence-based guidelines are an attempt to reconcile conflicting lines of evidence, giving greater weight to evidence derived from more methodologically rigorous studies and those for which the overall weight of evidence is most convincing. Although they must be viewed as guidelines and recommendations, not absolutes, they have become a very useful tool in daily practice, and underline the importance of teamwork in the management of blood transfusion.