The most effective method for achieving sustainable blood-sparing practices is a pragmatic and individualized approach within a multidisciplinary framework. For every case, direct, clear, and intentional communication within a team-of-teams environment is sine qua non. Regular reassessment of protocols and outcomes allows integration of new evidence, incorporation of multidisciplinary feedback, and alignment with institutional and broader best-practice standards. This continuous quality

Typical transfusion triggers may include bilateral NIRS drop of 20% or more from baseline, mixed venous saturation below 70%, rising lactate or decreased urine output unresponsive to changes in blood pressure, and CPB flow that is inappropriate for patient’s temperature. This can occur even if the HCT is above 21%. The decision to transfuse is made after discussions among the surgeon, anesthesiologist, and perfusionist in a real-time, collaborative manner. Other important considerations include 

Between August 1, 2020, and August 31, 2025, 1391 patients underwent surgery with CPB for the repair of CHD at our institution. Median age and weight at the time of surgery were 603 days (interquartile range, 160-3364) and 10.5 kg (interquartile range, 5.8-30.65), respectively. A total of 229 patients (16.5%) underwent univentricular palliation, 1107 patients (79.6%) received biventricular repair, and 55 patients (3.9%) received a heart transplant. A total of 83.7% of patients (n = 1164) had

A blood-conservation program is a team sport consisting of providers with a singular focus of blood preservation while ensuring best practices and requires buy-in and promotion from a multidisciplinary perspective.