Patient blood management in Brazilian cardiovascular surgery: An exploratory survey of surgeons' perceptions and reported practices.

INTRODUCTION

Although the clinical benefits of patient blood management are internationally recognized, data regarding its implementation in Brazilian cardiovascular surgery remain limited. This study evaluated knowledge on patient blood management, reported practices, and perceived barriers among Brazilian cardiovascular surgeons.

METHODS

This cross-sectional survey was conducted among 1,105 cardiovascular surgeons registered with the Brazilian Society of Cardiovascular Surgery. A 30-item questionnaire assessing professional characteristics, preoperative anemia management, perioperative transfusion practices, and patient blood management adoption was distributed via email. Descriptive and inferential statistical analyses were performed.

RESULTS

The response rate was 19.4% (n = 205). Most respondents were male (91%) and based in the southeastern region. Preoperative anemia screening and management were heterogeneous. Thirty-one percent estimated the prevalence of preoperative anemia at 5%-15% in their institutions, and 43% reported hemoglobin testing 1-2 days before surgery. Approximately 25% routinely calculated erythrocyte mass and blood volume. Institutional transfusion risk protocols were reported by 48% of respondents, and 62% indicated standardized blood component request parameters. Antifibrinolytics and hemostatic agents were the most frequently reported coagulation strategies. Interest in patient blood management implementation was reported by 52%; perceived barriers included cultural resistance (43%), financial constraints (24%), and administrative challenges (21%). A statistically significant association was observed between geographic region and reported interest in patient blood management implementation.

CONCLUSION

Patient blood management implementation was reported as heterogeneous across institutions. Respondents identified cultural, economic, and structural barriers to patient blood management implementation. These findings reflect surgeons' self-reported perceptions and should be interpreted within the limitations of a cross-sectional survey with limited regional representativeness.