![]() ![]() ![]() With an increased focus on providing value-based care by improving patient outcomes and decreasing costs, attention has turned to the role of patient blood management (PBM) to reduce unnecessary transfusions for patients undergoing cardiac surgery (Spahn et al. We address each topic individually, and provide a list of focused research questions (Table 1) which we believe represent high priority areas for perioperative cardiac researchers to address. These topics are patient blood management, goal-directed therapy, acute kidney injury, opioid analgesic reduction, and delirium. We have focused on five topics-those in which we believe there are answerable questions that address specific problems faced by cardiac surgical patients, and in which well-designed research studies will advance the field by providing specific answers. The specific goal of this paper therefore is to review those areas of high importance, themselves defined as areas in which there is significant controversy about how best to manage patients. Recognizing that best practice comes from research addressing genuine evidence gaps, these two groups have developed this brief review of important topics in perioperative medicine related to cardiac surgery. The Perioperative Quality Initiative (POQI) and Enhanced Recovery After Surgery–Cardiac Society (ERAS→-Cardiac) organizations are both committed to excellence in perioperative medicine, and in particular for patients undergoing high-risk surgery (Shannon et al. This reflects a relative lack of evidence in the field and has led to differences in treatment plans for patients undergoing the same procedure, usually in different centers but sometimes even within the same institution. While consensus has emerged in some areas of perioperative management for patients undergoing heart surgery, considerable differences of opinion remain for others. 2019 Gupta and Senagore 2017), but more recently they have also been applied to cardiac surgery patients (Engelman et al. ![]() These protocols have typically been applied to non-cardiac surgical populations (Wennström et al. Enhanced Recovery After Surgery (ERAS) programs have become ubiquitous in the field of perioperative medicine and have played a key role in defining the essence of this relatively young discipline. ![]()
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