2010 MSARF Symposium Participants - Foundation for Anesthesia ...

Student Name: Michael Kreger
Host Department: Vanderbilt University
Primary Mentor Name: Gina Whitney, MD
Additional Mentors: Brian Donahue, MD, PhD
Title of Research Project: Reduction in Intraoperative Blood Product Administration Following Introduction of a
Standardized Transfusion Protocol
Transfusion is common following cardiopulmonary bypass in children. While transfusion is often life-sustaining, blood
products are also associated with mortality, infection, and duration of mechanical ventilation. Transfusion in pediatric
cardiac surgery is often based on clinical judgment rather than objective data, possibly leading to overutilization and
increased patient morbidity. Although objective transfusion algorithms have demonstrated efficacy for reducing
transfusion and improving outcome in adult cardiac surgery, such algorithms have not been applied in the pediatric
setting. To measure the impact of an objective, laboratory-guided transfusion algorithm in pediatric cardiac surgery, we
devised an evidence-based transfusion protocol to be implemented in January 2011, and we monitored the subsequent
impact of this algorithm on blood utilization, both in the operating room and during the first 12 hours following ICU
admission. When compared with the 5 months preceding implementation, blood utilization in the operating room for the
5 months following implementation decreased by 69% for red cells (p=0.022), and 88% for cryoprecipitate (p