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3. Pain management and opioid stewardship in adult cardiac surgery: Joint consensus report of the PeriOperative Quality Initiative and the Enhanced Recovery After Surgery Cardiac Society

Author

Shaw, Andrew D., Engelman, Daniel, Mythen, Michael, Guinn, Nicole R., Aronson, Solomon, Schwartz, Jonathon, Arora, Rakesh C., Morton-Bailey, Vicky, Brudney, C. Scott, Bennett-Guerrero, Elliott, Reddy, V. Seenu, Guzzi, Lou, Brown, Jessica, Crisafi, Cheryl, Grant, Michael C., Chappell, Desiree, Gan, Tong J., Manning, Michael W., Miller, Timothy E., and Brodt, Jessica L.

Published
2023
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10. Use of a Preoperative Screening Tool to Optimize Patients with Anemia Before Cardiac Valve Procedures

Author

Jones, Emily, Guinn, Nicole R., Rice, Andi N., and Vacchiano, Charles A.

Subjects
Usage, Quality control, Medical tests -- Usage, Quality control -- Usage, Cardiac patients -- Usage, Anemia -- Usage
Abstract

This quality improvement project focused on identifying and treating preoperative anemia in patients undergoing cardiac valve surgery. A standardized screening checklist and procedure for patient referral to a preoperative anemia [...]

Published
2020

12. Essential Role of Patient Blood Management in a Pandemic: A Call for Action

Author

Shander, Aryeh, Goobie, Susan M., Warner, Matthew A., Aapro, Matti, Bisbe, Elvira, Perez-Calatayud, Angel A., Callum, Jeannie, Cushing, Melissa M., Dyer, Wayne B., Erhard, Jochen, Faraoni, David, Farmer, Shannon, Fedorova, Tatyana, Frank, Steven M., Froessler, Bernd, Gombotz, Hans, Gross, Irwin, Guinn, Nicole R., Haas, Thorsten, Hamdorf, Jeffrey, Isbister, James P., Javidroozi, Mazyar, Ji, Hongwen, Kim, Young-Woo, Kor, Daryl J., Kurz, Johann, Lasocki, Sigismond, Leahy, Michael F., Lee, Cheuk-Kwong, Lee, Jeong Jae, Louw, Vernon, Meier, Jens, Mezzacasa, Anna, Munoz, Manuel, Ozawa, Sherri, Pavesi, Marco, Shander, Nina, Spahn, Donat R., Spiess, Bruce D., Thomson, Jackie, Trentino, Kevin, Zenger, Christoph, and Hofmann, Axel

Published
2020
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16. Adult Cardiac Surgery Associated Acute Kidney Injury: Joint Consensus Report of the PeriOperative Quality Initiative (POQI) and the Enhanced Recovery After Surgery (ERAS®) Cardiac Society

Author

Brown, Jessica K., primary, Shaw, Andrew D., additional, Mythen, Monty G., additional, Guzzi, Lou, additional, Reddy, V. Seenu, additional, Crisafi, Cheryl, additional, Engelman, Daniel T., additional, Shaw, Andrew D, additional, Engelman, Daniel T, additional, Gan, TJ, additional, Miller, Timothy, additional, Mythen, Monty G, additional, Guinn, Nicole R, additional, Aronson, Solomon, additional, Schwartz, Jonathon, additional, Arora, Rakesh C, additional, Morton-Bailey, Vicki, additional, Brudney, C Scott, additional, Bennett-Guerrero, Elliott, additional, Reddy, V Seenu, additional, Brown, Jessica, additional, Brodt, Jessica, additional, Grant, Michael C., additional, Manning, Michael, additional, and Chappell, Desiree, additional

Published
2023
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17. Pain Management and Opioid Stewardship in Adult Cardiac Surgery: Joint Consensus Report of the PeriOperative Quality Initiative and the Enhanced Recovery After Surgery Cardiac Society

Author

Grant, Michael C., primary, Chappell, Desiree, additional, Gan, Tong J., additional, Manning, Michael W., additional, Miller, Timothy E., additional, Brodt, Jessica L., additional, Shaw, Andrew D., additional, Engelman, Daniel, additional, Mythen, Michael, additional, Guinn, Nicole R., additional, Aronson, Solomon, additional, Schwartz, Jonathon, additional, Arora, Rakesh C., additional, Morton-Bailey, Vicky, additional, Brudney, C Scott, additional, Bennett-Guerrero, Elliott, additional, Reddy, V Seenu, additional, Guzzi, Lou, additional, Brown, Jessica, additional, Crisafi, Cheryl, additional, and Grant, Michael C., additional

Published
2023
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35. Treatment through a preoperative anemia clinic is associated with a reduction in perioperative red blood cell transfusion in patients undergoing orthopedic and gynecologic surgery.

Author

Guinn, Nicole R., Fuller, Matt, Murray, Sutton, and Aronson, Solomon

Abstract

Background: Preoperative anemia is associated with increased morbidity, mortality, and risk of transfusion. Treatment through a preoperative anemia clinic (PAC) may improve outcomes. Study Design and Methods: Adult patients undergoing elective orthopedic and gynecologic surgery with preoperative anemia were identified and referred for hemoglobin optimization with iron and/or erythropoietin from a single‐site academic health center. Treated patients were propensity matched to untreated controls and compared on outcomes of erythrocyte transfusion, length of stay (LOS), and readmission. Changes in hemoglobin relative to treatment time before surgery were also measured in the treated cohort. Results: One thousand three hundred thirty‐two patients were evaluated between July 2015 and March 2021, of which 161 underwent optimization through the PAC. After propensity matching, 127 (98 orthopedic and 29 gynecology) PAC‐treated patients were compared to 127 (98 orthopedic and 29 gynecology) control patients who did not undergo treatment. The primary outcome of perioperative transfusion was significantly lower in treated patients compared with matched controls (12.60% vs. 26.77%, p =.005). A lower LOS was demonstrated in the gynecologic PAC subgroup (2.2 [1.5, 2.4] vs. 3.1 [2.2, 3.4], p =.002). Each day of treatment time before surgery was associated with an increase of 0.040 g/dL hemoglobin (p <.001) until 65 days, after which further time did not increase hemoglobin. Conclusion: Treatment through a preoperative anemia clinic is associated with a reduction in perioperative transfusion and possible reduction in LOS and readmission compared with matched controls. Additionally, treatment time before surgery is correlated with a greater increase in hemoglobin up until 2 months prior to surgery. [ABSTRACT FROM AUTHOR]

Published
2022
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37. How do I develop a process to effectively treat parturients with iron deficiency anemia?

Author

Guinn, Nicole R., Cooter, Mary L., Maisonave, Yasmin, Grimsley, Aime, Cellura, Cindy, Grotegut, Chad A., Lamon, Agnes, and Aronson, Solomon

Subjects
*IRON deficiency anemia, *IRON deficiency, *ETIOLOGY of diseases, *INTRAVENOUS therapy, *PREGNANT women
Abstract

Anemia is common in pregnant women and is associated with increased morbidity for the mother and the fetus, including increased risk of allogeneic blood transfusion. Iron deficiency is the most common etiology for anemia during pregnancy. Oral iron therapy remains the standard treatment but is often poorly tolerated due to its gastrointestinal side effects. Intravenous iron has been shown to be a safe and effective way to treat iron deficiency anemia but may be challenging to do in the outpatient setting given the need for an indwelling venous catheter and a small risk of infusion reactions. To improve outcomes associated with anemia, we launched a program to refer and treat obstetric patients with iron deficiency anemia for outpatient intravenous iron therapy through our preoperative anemia clinic. Here, we describe the process and successes of our program, including the clinical outcomes (change in hemoglobin and transfusion rates) from the first 2 years of the program. [ABSTRACT FROM AUTHOR]

Published
2020
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39. Pre- and postoperative anemia, acute kidney injury, and mortality after coronary artery bypass grafting surgery: a retrospective observational study

Author

Oprea, Adriana D., primary, Del Rio, J. Mauricio, additional, Cooter, Mary, additional, Green, Cynthia L., additional, Karhausen, Jörn A., additional, Nailer, Patrick, additional, Guinn, Nicole R., additional, Podgoreanu, Mihai V., additional, Stafford-Smith, Mark, additional, Schroder, Jacob N., additional, Fontes, Manuel L., additional, and Kertai, Miklos D., additional

Published
2017
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45. Return on Investment of Preoperative Anemia Management Programs in Cardiac Surgery: An Advisory From the Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Committee With Endorsement by the Society for the Advancement of Patient Blood Management

Author

Warner, Matthew A., Ferreira, Renata, Raphael, Jacob, Shore-Lesserson, Linda, Grant, Michael C., Sykes Hill, Shanna, Morewood, Gordon, Popescu, Wanda M., Schwann, Nanette, and Guinn, Nicole R.

Abstract

Despite multiple recent guidelines recommending the diagnosis and treatment of anemia before elective cardiac surgery, few institutions have formal programs or methods in place to accomplish this. A major limitation is the perceived financial shortfall and the leadership buy-in required to undertake such an initiative. The purpose of this advisory from the Society of Cardiovascular Anesthesiologists (SCA) Clinical Practice Improvement Committee with endorsement by the Society for the Advancement of Patient Blood Management (SABM) is to provide an overview of preoperative anemia management programs with an emphasis on the associated financial implications. This advisory reviews the evidence for preoperative anemia management programs in both cardiac and noncardiac surgery, discusses options for managing preoperative anemia, provides novel financial modeling regarding the implementation of preoperative anemia management programs, and describes implementation challenges, potential solutions, and opportunities for improvement.

Published
2024
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46. Anémie pré- et postopératoire, insuffisance rénale aiguë, et mortalité après une chirurgie de pontage aortocoronarien : une étude observationnelle rétrospective.

Author

Oprea, Adriana D., Del Rio, J. Mauricio, Cooter, Mary, Green, Cynthia L., Karhausen, Jörn A., Nailer, Patrick, Guinn, Nicole R., Podgoreanu, Mihai V., Stafford-Smith, Mark, Schroder, Jacob N., Fontes, Manuel L., and Kertai, Miklos D.

Subjects
ACADEMIC medical centers, ACUTE kidney failure, ANEMIA, CORONARY artery bypass, CREATININE, HEMOGLOBINS, POSTOPERATIVE period, SURGICAL complications, DISEASE incidence, PROPORTIONAL hazards models, RETROSPECTIVE studies, PREOPERATIVE period, DISEASE complications
Abstract

Copyright of Canadian Journal of Anaesthesia / Journal Canadien d'Anesthésie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2018
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47. Platelet Counts and Postoperative Stroke After Coronary Artery Bypass Grafting Surgery

Author

Karhausen, Jörn A., Smeltz, Alan M., Akushevich, Igor, Cooter, Mary, Podgoreanu, Mihai V., Stafford-Smith, Mark, Martinelli, Susan M., Fontes, Manuel L., Kertai, Miklos D., Aronson, Solomon, Bartz, Raquel R., Bottiger, Brandi A., Cherry, Anne D., Colin, Brian J., Del Rio, J. Mauricio, Fierro, Michael, Ghadimi, Kamrouz, Guinn, Nicole R., Iboaya, Ehimemen, Jones-Haywood, Mandisa, Klinger, Rebecca Y., Konoske, Ryan, Levy, Jerrold H., Lombard, F. Willem, Maisonave, Yasmin, Manning, Michael W., Mathew, Joseph P., Maxwell, Corry D., McCarthy, Grace C., Newman, Mark F., Nicoara, Alina, Quinones, Quintin J., Swaminathan, Madhav, Thompson, Annemarie, Vega, Eleanor A., Welsby, Ian J., Balajonda, Narai, Bisanar, Tiffany, Brassard, Rachele, Funk, Bonita L., Hall, Roger L., Lane, Kathleen, Li, Yi-Ju, Mbocchi, Galdwell, Pecora, Greg, Pender, Michelle, Phillips-Bute, Barbara, Solon, Prometheus T., Toulgoat-Dubois, Yanne, Waweru, Peter, White, William D., Collins, Kevin, Shearer, Ian, Smigla, Greg, D’Amico, Thomas A., Daneshmand, Mani A., Davis, R. Duane, Gaca, Jeffrey G., Glower, Donald D., Haney, John, Harpole, R. David, Hartwig, Matthew G., Hughes, G. Chad, Jaquiss, Robert D.B., Lin, Shu S., Lodge, Andrew J., Milano, Carmelo A., Onaitis, Mark W., Schroeder, Jacob N., Smith, Peter K., and Tong, Betty C.

Abstract

Published ahead of print June 17, 2017.

Published
2017
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50. Practice Advisory on the Implementation of Preoperative Anemia Management: The Society of Cardiovascular Anesthesiologists and the Society for the Advancement of Patient Blood Management.

Author

Klompas AM, Hensley NB, Burt JM, Grant MC, Guinn NR, Patel PA, Popescu WM, Raphael J, Salenger R, Shore-Lesserson L, and Warner MA

Abstract

Preoperative anemia is common and associated with worse outcomes in cardiac surgery including acute kidney injury, red blood cell transfusion, cardiovascular complications, stroke, infection, and death. Patient blood management programs, which include dedicated clinical programs to diagnose and treat anemia in advance of surgery (ie, preoperative anemia programs), have been highlighted as a means to optimize the blood health of each patient, thereby decreasing risk for allogeneic transfusion and improving clinical outcomes. However, there remain implementation challenges for preoperative anemia programs, including difficulties with education of patients and staff, short lead times to address anemia, infrastructure and staffing limitations, lack of clear leadership or ownership of preoperative anemia, the need to develop treatment algorithms and ensure appropriate infusion therapy support, lack of capital support, and insurance/reimbursement concerns, amongst others. The purpose of this advisory from the Society of Cardiovascular Anesthesiologists (SCA) Clinical Practice Improvement Committee and the Subcommittee on Patient Blood Management with endorsement from the Society for the Advancement of Patient Blood Management (SABM) is to provide guidance on the development and implementation of a preoperative anemia clinic or service line, including identification and navigation through potential logistical barriers. A detailed analysis of financial incentives is highlighted in our companion article in this edition focuses on the return on investment of anemia management. Although originating with a focus on anemia before cardiac surgery, this advisory is broadly applicable to all perioperative patients., Competing Interests: Conflicts of Interest, Funding: Please see DISCLOSURES at the end of this article., (Copyright © 2024 International Anesthesia Research Society.)

Published
2024
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