Cardiopulmonary bypass-induced coagulopathy is a serious complication that may result in massive bleeding requiring transfusion of multiple units of red blood cells and pro-coagulant products. Up to 10 percent of cardiac surgery patients suffer from massive blood loss (chest tube bleeding >2,000 ml over the first 24 hours after surgery, or the need to transfuse 10 red blood cell [RBC] units, or more, over a 24-hour period) and up to 5 percent of all patients having cardiac surgery require emergent chest re-exploration to achieve hemostasis. Thus, timely control of coagulopathy is of prime importance in order to avoid the sequelae of excessive bleeding. A significant body of evidence has associated allogeneic blood transfusions during cardiac surgery with increased risk of perioperative complications and mortality. Despite this evidence base, and despite the publication of transfusion guidelines,4...

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