KUMJ | VOL. 24 | NO. 2 | ISSUE 95 | APRIL - JUNE, 2026

Practice Prevalence of Blood Transfusion Practices in the Tertiary Cardiac Center of Nepal
Amatya AG, Pudasaini A, Gandi A, Bhusal S, Dhakal S, Yadav RK, Shrestha A, Thapa R, Shrestha S, Shrestha BM, Pandey P, Shakya L, Karkee A, Bajracharya SM, Shrestha BK, Bhandari S

Abstract:
Background Cardiac surgery frequently results in bleeding, requiring transfusion of blood and blood components. Transfusion is associated with increased postoperative morbidity and mortality. Viscoelastic testing, such as rotational thromboelastometry, may reduce unnecessary transfusion. Objective To assess the prevalence of blood transfusion practices, morbidity and mortality of patients admitted during the study period. Method This cross-sectional descriptive study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal. A retrospective analysis was performed on patients aged eighteen years and older who underwent open-heart surgery between June 30, 2022, and June 30, 2023. Data were collected on transfusion prevalence and use of viscoelastic testing. Postoperative outcomes, including re-exploration, acute kidney injury, acute lung injury, duration of intensive care, hospital stay, and in-hospital mortality, were recorded. Result Among 897 patients, 403 (44.9%) received blood transfusions. Viscoelastic testing could only be used in 20.3 percent of cases evaluated for transfusion, and transfusion was completely avoided in 18.5 percent following viscoelastic test-guided intervention. Major postoperative complications included acute lung injury (42.2%), acute kidney injury (9.1%), and re-exploration (6.8%). In-hospital mortality was 4.6 percent. Conclusion Transfusion was altogether avoided in 18.5% of cases and was instrumental in guiding the appropriate intervention in the remaining 81.4%, who were managed using rotational thromboelastometry , highlighting the role of viscoelastic testing in reducing as well as effectively managing postoperative bleeding in cardiac surgery. However, adhering to the standard goal-directed protocol might in all cases have resulted in even better outcomes.
Keyword : Bleeding, Cardiac surgery, Point of care coagulation