IMPACT OF PATIENT BLOOD MANAGEMENT (PBM) PROTOCOL IMPLEMENTATION IN PATIENTS UNDERGOING CARDIAC SURGERY AT HOSPITAL DE CLÍNICAS: A BEFORE-AND-AFTER STUDY (MAY 2023–APRIL 2025)
- 1Unidad Académica Medicina Transfusional. Hospital de Clínicas, Universidad de la República, UdelaR. Montevideo, Uruguay
Abstract
Introduction: PBM is an essential strategy in contemporary medical practice, particularly in cardiac surgery, where transfusion of blood components is frequently required. It aims to optimize the management of the patient's own blood in order to improve clinical outcomes. Hospital de Clínicas has implemented a PBM protocol based on international principles and adapted to the local healthcare context in Uruguay, strengthening coordination among the multidisciplinary teams involved in patient care. Objectives: Evaluate the impact of the implementation of a PBM program in patients undergoing cardiac surgery at our hospital by comparing outcomes during the pre and post implementation periods Materials and methods: An observational study was conducted including 281 patients who underwent elective cardiac surgery between May 2023 and April 2025. Quantitative variables were described using measures of central tendency and dispersion, while qualitative variables were expressed as absolute and relative frequencies. For comparative analysis between groups, the chi-square test was used for qualitative variables and Student’s t-test for quantitative variables. Results: Statistically significant differences were observed in the frequency of infectious complications between the two groups. In addition, the proportion of mortality during hospitalization was significantly higher in the period prior to the implementation of the protocol. The use of rotational thromboelastometry (ROTEM) decreased from 39% during the pre-PBM implementation period to 18% after implementation. A reduction in the incidence of infectious complications and mortality during hospitalization was also observed, with statistically significant differences between the pre- and post-PBM implementation periods. Discussion: One of the main barriers to PBM implementation at our institution is the lack of interdisciplinary and interinstitutional coordination. In Uruguay, cardiac surgery is performed at Highly Specialized Medical Institutes, resulting in delays in patient referral and assessment by specialists in Transfusion Medicine. This represents a major challenge, particularly for patients with preoperative anemia, who would benefit from hemoglobin optimization before surgery. Conclusion: The implementation of PBM in cardiac surgery represents a paradigm shift aimed at optimizing transfusion practice, reducing unnecessary exposure to blood components, and improving perioperative clinical outcomes. This study has several limitations that should be acknowledged. First, it was conducted at a single center, which may limit the generalizability of the findings to other institutions. Future multicenter studies including larger patient populations are warranted to validate and expand upon these results. Despite these limitations, our findings suggest that implementing a PBM protocol is an effective strategy for optimizing transfusion practice in patients undergoing cardiac surgery.
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BibTeX
@article{grasso2026impact,
title = {{IMPACT OF PATIENT BLOOD MANAGEMENT (PBM) PROTOCOL IMPLEMENTATION IN PATIENTS UNDERGOING CARDIAC SURGERY AT HOSPITAL DE CLÍNICAS: A BEFORE-AND-AFTER STUDY (MAY 2023–APRIL 2025)}},
author = {Eugenia GRASSO and Alicia LAY and Rodrigo ANTURIANO and Florencia BENTANCOUR and Patricia AGUIRREZABAL and Felipe LEMOS},
journal = {Hematology, Transfusion and Cell Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.107297},
url = {https://doi.org/10.1016/j.htct.2026.107297},
note = {CC BY},
}
RIS
TY - JOUR
TI - IMPACT OF PATIENT BLOOD MANAGEMENT (PBM) PROTOCOL IMPLEMENTATION IN PATIENTS UNDERGOING CARDIAC SURGERY AT HOSPITAL DE CLÍNICAS: A BEFORE-AND-AFTER STUDY (MAY 2023–APRIL 2025)
AU - Eugenia GRASSO
AU - Alicia LAY
AU - Rodrigo ANTURIANO
AU - Florencia BENTANCOUR
AU - Patricia AGUIRREZABAL
AU - Felipe LEMOS
PY - 2026
DA - 2026/10/23
JO - Hematology, Transfusion and Cell Therapy
DO - 10.1016/j.htct.2026.107297
UR - https://doi.org/10.1016/j.htct.2026.107297
AB - Introduction: PBM is an essential strategy in contemporary medical practice, particularly in cardiac surgery, where transfusion of blood components is frequently required. It aims to optimize the management of the patient's own blood in order to improve clinical outcomes. Hospital de Clínicas has implemented a PBM protocol based on international principles and adapted to the local healthcare context in Uruguay, strengthening coordination among the multidisciplinary teams involved in patient care. Objectives: Evaluate the impact of the implementation of a PBM program in patients undergoing cardiac surgery at our hospital by comparing outcomes during the pre and post implementation periods Materials and methods: An observational study was conducted including 281 patients who underwent elective cardiac surgery between May 2023 and April 2025. Quantitative variables were described using measures of central tendency and dispersion, while qualitative variables were expressed as absolute and relative frequencies. For comparative analysis between groups, the chi-square test was used for qualitative variables and Student’s t-test for quantitative variables. Results: Statistically significant differences were observed in the frequency of infectious complications between the two groups. In addition, the proportion of mortality during hospitalization was significantly higher in the period prior to the implementation of the protocol. The use of rotational thromboelastometry (ROTEM) decreased from 39% during the pre-PBM implementation period to 18% after implementation. A reduction in the incidence of infectious complications and mortality during hospitalization was also observed, with statistically significant differences between the pre- and post-PBM implementation periods. Discussion: One of the main barriers to PBM implementation at our institution is the lack of interdisciplinary and interinstitutional coordination. In Uruguay, cardiac surgery is performed at Highly Specialized Medical Institutes, resulting in delays in patient referral and assessment by specialists in Transfusion Medicine. This represents a major challenge, particularly for patients with preoperative anemia, who would benefit from hemoglobin optimization before surgery. Conclusion: The implementation of PBM in cardiac surgery represents a paradigm shift aimed at optimizing transfusion practice, reducing unnecessary exposure to blood components, and improving perioperative clinical outcomes. This study has several limitations that should be acknowledged. First, it was conducted at a single center, which may limit the generalizability of the findings to other institutions. Future multicenter studies including larger patient populations are warranted to validate and expand upon these results. Despite these limitations, our findings suggest that implementing a PBM protocol is an effective strategy for optimizing transfusion practice in patients undergoing cardiac surgery.
SN - 2531-1379
SN - 2531-1387
ER -