{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:34:43Z","timestamp":1786649683782,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"\n Background:<\/jats:title>\n The purpose of this survey was to delineate and compare patient blood management (PBM) approaches in cardiac surgery across nine Middle Eastern countries while identifying the main challenges against the implementation of the PBM program in cardiac surgery as reported by the surveyed centers.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n An online survey was established to assess current PBM practices in surveyed countries, including risk factors for bleeding or transfusion, management of preoperative anemia in elective cases, and antifibrinolytic use.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n This questionnaire was conducted among cardiac anesthesiologists in Middle Eastern countries in 2024.<\/jats:p>\n <\/jats:sec>\n \n Participants:<\/jats:title>\n Only doctors participated voluntarily in this survey.<\/jats:p>\n <\/jats:sec>\n \n Interventions:<\/jats:title>\n No intervention.<\/jats:p>\n <\/jats:sec>\n \n Measurements:<\/jats:title>\n We assessed the extent of adoption of PBM practices in surveyed countries for patients who underwent cardiac surgery with cardiopulmonary bypass.<\/jats:p>\n <\/jats:sec>\n \n Main Results:<\/jats:title>\n \n Of 40 survey responses, 26 (60%) were eligible for analysis. Most respondents were cardiac anesthesiologists. Key risk factors of bleeding or transfusion identified by over 70% of respondents included redo cardiac surgery, preoperative anemia, recent clopidogrel use, thrombocytopenia <100 \u00d7 10\n 9<\/jats:sup>\n \/L, and oral anticoagulants. More than half of the centers would correct preoperative anemia using iron. Tranexamic acid was universally used, though administration regimens varied. Autologous priming and normothermia were the most common bypass strategies that would be used by more than 50% of respondents. Viscoelastic testing was available in more than 70% of centers and used by more than half of respondents in case of clinical bleeding.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n PBM practices in Middle Eastern cardiac centers are heterogeneous, reflecting inconsistent adoption of guidelines. Enhanced training, institutional support, and homogenized national protocols are needed to standardize PBM in the region.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/sja.sja_142_25","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:00:46Z","timestamp":1756900846000},"page":"587-593","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Patient blood management for patients undergoing cardiac surgery in Middle Eastern countries: Multicenter survey"],"prefix":"10.4103","volume":"19","author":[{"given":"Ahmed","family":"Abdalwahab","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt"},{"name":"Department of Anesthesia, Prince Sultan Cardiac Centre, Riyadh, KSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abuzaid","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Prince Sultan Cardiac Centre, Riyadh, KSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossam","family":"Walley","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Saud Al-Babatin Cardiac Centre, Dammam, KSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doaa Fawzy","family":"Abdelfattah","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A.","family":"Elmetwally","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt"},{"name":"Department of Anesthesia, National Heart Centre, Royal Hospital, Muscat, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Elsherbeny","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Faculty of Medicine, Cairo 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product use, postoperative bleeding and air entrainment: An in vivo clinical perspective","volume":"31","author":"Perthel","year":"2007","journal-title":"Eur J Cardiothorac Surg"},{"key":"R15-20260421","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1177\/0267659110371705","article-title":"Mini extracorporeal circuit cardiopulmonary bypass system: A review","volume":"25","author":"Curtis","year":"2010","journal-title":"Perfusion"},{"key":"R16-20260421","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s13019-018-0739-0","article-title":"Positive impact of retrograde autologous priming in adult patients undergoing cardiac surgery: A randomized clinical trial","volume":"13","author":"Hofmann","year":"2018","journal-title":"J Cardiothorac Surg"},{"key":"R17-20260421","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1051\/ject\/201951100","article-title":"Retrograde autologous priming technique to reduce Hemodilution during cardiopulmonary bypass in the pediatric cardiac patient","volume":"51","author":"Hagedorn","year":"2019","journal-title":"J Extra Corpor Technol"},{"key":"R18-20260421","doi-asserted-by":"crossref","first-page":"110311","DOI":"10.1016\/j.jclinane.2021.110311","article-title":"A survey of patient blood management for patients undergoing cardiac surgery in nine European countries","volume":"72","author":"Klein","year":"2021","journal-title":"J Clin Anesth"},{"key":"R19-20260421","doi-asserted-by":"crossref","first-page":"e20190297","DOI":"10.1590\/1983-1447.2020.20190297","article-title":"Online data collection strategies used in qualitative research of the health field: A scoping review","volume":"41","author":"Salvador","year":"2020","journal-title":"Rev Gaucha Enferm"}],"container-title":["Saudi Journal of 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