This observational, retrospective before-and-after single-centre study reports that the reduction of intraoperative haemodilution obtained through a decrease in the amount of fluid administered before and during the cardiopulmonary bypass may be associated with an increased proportion of patients avoiding post-bypass RBC transfusions during elective primary coronary artery bypass graft surgery. However, the magnitude of this effect appears markedly reduced by the huge variability in transfusion practice observed among anaesthesiologists who participated in the study. These results emphasise once again that standardising the transfusion policy among the different caregivers is the first step to be implemented when developing a patient blood management programme.

– Philippe Van der Linden