Schulich school of Medicine and Dentistry logo Anesthesia and Perioperative Medicine Schulich School of Medicine & Dentistry

Dr. Fiona Ralley

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Professor
Director of Perioperative Patient Blood Management








Biography

Dr. Fiona Ralley was born in Edinburgh, Scotland and completed her medical degree from the University of Edinburgh Medical School. After completing her anesthesia residency training at the Royal Infirmary in Edinburgh, Scotland, Dr. Ralley moved to Canada to complete a two year Cardiac/Transplantation Anesthesia Fellowship at the Royal Victoria Hospital in Montréal, Quebec. She then joined the Department of Anesthesia at McGill University, Montreal, Canada.

In 1999, Dr. Ralley moved from Montréal to her current position in London, Ontario.

Dr. Ralley is the founding director of the Perioperative Blood Conservation Program in 2003 which now reviews preoperatively over 2500 patients per year undergoing predominantly orthopedic, vascular, and cardiac procedures.

She is also Chair of the City Wide Blood Transfusion Committee at London Health Sciences Centre. Since 2007, Dr. Ralley has been a member of the MOHLTC Working Group for the Ontario Contingency Plan for Management of Blood Shortages and the Ontario Emergency Blood Management Committee.

Dr. Ralley is currently a member of the editorial board of the Journal of Cardiothoracic and Vascular Anesthesia and is a reviewer for the Canadian Journal of Anesthesia, European Journal of Anaesthesia, Anesthesia and Analgesia and Liver Transplantation. She is also a past president of the Cardiovascular & Thoracic Section, Canadian Anesthesiologists’ Society and a past member of the Scientific Program Committee of the Society of Cardiovascular Anesthesiologists.

Her past research interests have focused on

  • The hematological complications associated with cardiopulmonary bypass
  • The use of antifibrinolytic agents to reduce blood loss associated with cardiac, orthopedic and transplant surgery
  • The management of heparin/protamine dosing for cardiopulmonary bypass

Currently, her main areas of research include

  • The use of acute normovolemic hemodilution to reduce blood transfusion rates in cardiac and non-cardiac surgery patients
  • The use of ROTEM to guide transfusion decisions in complex cardiac surgical procedures
  • Blood conservation strategies to reduce patient exposure to blood products in cardiac and orthopedic surgery

Honours

Dr. Fiona Ralley was nominated to the Board of Directors for the Society for the Advancement of Blood Management (SABM). She began her new role with SABM in September of 2010, and continues to present. 

Recent Publications

Louzada ML, Hsia CC, Al-Ani F, Ralley F, Xenocostas A, Martin J, Connelly SE, Chin-Yee IH, Minuk L, Lazo-Langner A. Randomized double-blind safety comparison of intravenous iron dextran versus iron sucrose in an adult non-hemodialysis outpatient population: A feasibility study. BMC Hematol. 2016 Mar 11;16:7

Ralley FE. Tranexamic acid: When is enough (data) enough? Can J Anaesth. 2015 Aug 26. [Epub ahead of print]

Karkouti K, Grocott HP, Hall R, Jessen ME, Kruger C, Lerner AB, MacAdams C, Mazer CD, de Medicis É, Myles P, Ralley F, Rheault MR, Rochon A, Slaughter MS, Sternlicht A, Syed S, Waters T. Interrelationship of preoperative anemia, intraoperative anemia, and red blood cell transfusion as potentially modifiable risk factors for acute kidney injury in cardiac surgery: a historical multicentre cohort study. Can J Anaesth. 2015 Apr;62(4):377-384. Epub 2014 Dec 24.

Karkouti K, Arellano R, Aye T, Dupuis JY, Kent B, Ralley F, et al. Off-label use of recombinant activated factor VII in surgical and non-surgical patients at 16 Canadian hospitals from 2007 to 2010 (Canadian Registry Report). Can J Anaesth. 2014 Aug;61(8):727-35.

Ralley FE. Erythropoietin and intravenous iron in PBM. Transfus Apher Sci. 2014 Feb;50(1):16-9.

Smit KM, Naudie DD, Ralley FE, Berta DM, Howard JL. One dose of tranexamic acid is safe and effective in revision knee arthroplasty. J Arthroplasty. 2013 Sep;28(8 Suppl):112-5.

Chu M, Losenno K, Moore K, Berta D, Hewitt J, Ralley F. Blood conservation strategies reduce the need for transfusions in ascending and aortic arch surgery. Perfusion. 2013 Jul;28(4):315-21.

Healey JS, Merchant R, Simpson C, Tang T, Beardsall M, Tung S, Fraser JA, Long L, van Vlymen JM, Manninen P, Ralley F, Venkatraghavan L, Yee R, Prasloski B, Sanatani S, Philippon F; Canadian Cardiovascular Society; Canadian Anesthesiologists' Society; Canadian Heart Rhythm Society. Canadian Cardiovascular Society/Canadian Anesthesiologists' Society/Canadian Heart Rhythm Society joint position statement on the perioperative management of patients with implanted pacemakers, defibrillators, and neurostimulating devices. Can J Cardiol. 2012 Mar-Apr;28(2):141-51.

Healey JS, Merchant R, Simpson C, Tang T, Beardsall M, Tung S, Fraser JA, Long L, van Vlymen JM, Manninen P, Ralley F, Venkatraghavan L, Yee R, Prasloski B, Sanatani S, Philippon F. Canadian Cardiovascular Society; Canadian Anesthesiologists' Society; Canadian Heart Rhythm Society. Society position statement : Canadian Cardiovascular Society/Canadian Anesthesiologists' Society/Canadian Heart Rhythm Society joint position statement on the perioperative management of patients with implanted pacemakers, defibrillators, and neurostimulating devices. Can J Anaesth. 2012 Apr;59(4):394-407.

Roy D, Ralley FE. Anesthetic management of a patient with dynamic left ventricular outflow tract obstruction with systolic anterior movement of the mitral valve undergoing redo-orthotopic liver transplantation. J Cardiothorac Vasc Anesth. 2012 Apr;26(2):274-6.

Ralley FE, Berta D, Binns V, Howard J, Naudie DD. One intraoperative dose of tranexamic Acid for patients having primary hip or knee arthroplasty. Clin Orthop Relat Res. 2010 Jul;468(7):1905-11.