Background and aims: 

The Joint Commission and the American Medical Association-Convened Physician Consortium for Performance Improvement reported that the blood transfusions are among the top 5 overused treatments in modern medicine.
Optimal management of blood transfusion is one of the most important factors that increase patient safety and special education is increasing all over the world in this regard. In our hospital, it is aimed to decrease the perioperative transfusion amount by multidisciplinary team approach. In this regard, a commission has been established in which anesthesiologist, intensivist, cardiovascular surgeon, blood bank unit and hospital administrators are involved. By organizing monthly regular meetings we try to develop new strategies. Our goal in this retrospective cohort study is to investigate the effects of periodic consensus meetings and trainings on perioperative blood transfusion by a team of different branches of medicine.

Materials and Methods: Following the Ethics Committee approval, between 2014 and 2016, patients over the age of 18 who underwent cardiac surgery and had blood transfusion were included in this study. The transfusions were calculated cumulatively, the change with respect to years was determined, as well as side effects and complications associated with transfusion. Patients’ cardiac reserves, preoperative and postoperative laboratory values, anticoagulant drug use frequency, transfused blood volume, complications and mortality rates were recorded. The types of surgery, reexploration rate, length of intensive care and hospital stay were recorded.

Results and discussion: Patients' age, BMI, EF value, COPD, DM, HT ratio, antimicrobial drug use did not differ between the years 2014, 2015 and 2016 (p> 0.05). The length of intensive care and hospital stay, amount of bleeding, mortality rate did not differ (p> 0.05). CBP and CX time in 2016, were significantly higher (p ˂ 0.05) than in 2014 and 2015 (Table 2). The amount of RBC, FFP, platelet, cryoprecipitate did not differ significantly (p> 0.05). Besides after 2014, an increase in the use of platelets was observed. The change in Hb, Htc, platelet and INR did not differ significantly (p> 0.05) in the pre-postoperative period.


Conclusions: 
Training on the restrictive use of blood products did not have a positive influence on blood transfusion in our study. It has been demonstrated that there are challenges in sufficiently transferring the knowledge to the clinical environment. 


07 / The effects of multidisciplinary team approach on blood and blood products transfusion