Grant: Operating Grant

Bleeding is a frequent complication that occurs during and following cardiac surgery. The causes of bleeding in cardiac surgery are multifactorial and complex including the loss of clotting proteins. Plasma transfusions, which will increase the levels of clotting proteins, are commonly given to patients to correct abnormal clotting tests and stop abnormal bleeding. While, cardiac surgery represents one of largest uses of plasma transfusions, there is considerable variation in how and when plasma is transfused. This means many plasma transfusions are given to patients who do not require plasma. These unnecessary transfusions result in unneeded costs to the health care system and may cause serious, life-threatening reactions. To improve how and when plasma is transfused, we need to understand the clinical context in which plasma transfusions are given and the relative influence of these factors on physicians who order transfusions. In this project, we will examine the current utilization of plasma transfusions in cardiac surgery, specifically related to the clinical factors that may influence physicians' decision to transfuse plasma. Additionally, as a secondary objective, we will look at the effects of plasma transfusions on clotting test results and blood loss. During a 2-month period, we will study all plasma transfusion in 6 Canadian cardiac surgery centres. We will collect information on all plasma transfusions given to cardiac surgery patients. At the time that physicians order a plasma transfusion, they will complete a questionnaire that will ask them to rate the importance of various clinical factors on their decision to order a plasma transfusion. We will also collect data on all cardiac surgery patients while they are monitored in an intensive care unit. This data will include blood loss, clotting tests, other blood transfusions, other laboratory tests and clinical details.