Patient blood management in the cardiac surgical setting: An updated overview.

Blood Loss, Surgical / prevention & control Blood Transfusion Cardiac Surgical Procedures Hemostasis Humans Perioperative Care
Anticoagulation Blood transfusion Cardiac surgery Coagulation factors Fibrinogen Hemostasis Point of care tests Prothrombin complex concentrates Transfusion thresholds

Journal

Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis
ISSN: 1473-0502
Titre abrégé: Transfus Apher Sci
Pays: England
ID NLM: 101095653

Informations de publication

Date de publication:
Aug 2019
Historique:
pubmed: 8 7 2019
medline: 23 1 2020
entrez: 8 7 2019
Statut: ppublish

Résumé

In cardiac surgical patients it is a complex challenge to find the ideal balance between anticoagulation and hemostasis. Preoperative anemia and perioperative higher transfusion rates are related to increased morbidity and mortality. Patient blood management (PBM) is an evidence based patient specific individualized protocol used in the perioperative setting in order to reduce perioperative bleeding and transfusion rates and to improve patient outcomes. The three pillars of PBM in cardiac surgery consist of optimization of preoperative erythropoiesis and hemostasis, minimizing blood loss, and improving patient specific physiological reserves. This narrative review focuses on the challenges with special emphasis on PBM in the preoperative phase and intraoperative transfusion management and hemostasis in cardiac surgery patients. It is a "must" that PBM is a collaborative effort between anesthesiologists, surgeons, perfusionists, intensivists and transfusion laboratory teams. This review represents an up to date overview over "PBM in cardiac surgery patients".

Identifiants

DOI: 10.1016/j.transci.2019.06.015 PMID: 31279649
pubmed: 31279649
pii: S1473-0502(19)30108-9
doi: 10.1016/j.transci.2019.06.015
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

397-407

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

L E Terwindt (LE)

Dept. of Anesthesiology, Academic Medical Center, University of Amsterdam, the Netherlands; Dept. of Intensive Care, Academic Medical Center, University of Amsterdam, the Netherlands.

A A Karlas (AA)

Dept. of Anesthesiology, Academic Medical Center, University of Amsterdam, the Netherlands; Dept. of Intensive Care, Academic Medical Center, University of Amsterdam, the Netherlands.

S Eberl (S)

Dept. of Anesthesiology, Academic Medical Center, University of Amsterdam, the Netherlands; Dept. of Intensive Care, Academic Medical Center, University of Amsterdam, the Netherlands.

M Wijnberge (M)

Dept. of Anesthesiology, Academic Medical Center, University of Amsterdam, the Netherlands; Dept. of Intensive Care, Academic Medical Center, University of Amsterdam, the Netherlands.

A H G Driessen (AHG)

Dept. of Anesthesiology, Academic Medical Center, University of Amsterdam, the Netherlands; Dept. of Intensive Care, Academic Medical Center, University of Amsterdam, the Netherlands.

D P Veelo (DP)

Dept. of Anesthesiology, Academic Medical Center, University of Amsterdam, the Netherlands; Dept. of Intensive Care, Academic Medical Center, University of Amsterdam, the Netherlands.

B F Geerts (BF)

Dept. of Anesthesiology, Academic Medical Center, University of Amsterdam, the Netherlands; Dept. of Intensive Care, Academic Medical Center, University of Amsterdam, the Netherlands.

M W Hollmann (MW)

Dept. of Anesthesiology, Academic Medical Center, University of Amsterdam, the Netherlands; Dept. of Intensive Care, Academic Medical Center, University of Amsterdam, the Netherlands.

A P J Vlaar (APJ)

Dept. of Anesthesiology, Academic Medical Center, University of Amsterdam, the Netherlands; Dept. of Intensive Care, Academic Medical Center, University of Amsterdam, the Netherlands. Electronic address: a.p.vlaar@amc.uva.nl.

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Classifications MeSH

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