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Sangrado y cirugia cardiaca

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4 papers 0 to 25 followers
Sibylle A Kozek-Langenecker, Aamer B Ahmed, Arash Afshari, Pierre Albaladejo, Cesar Aldecoa, Guidrius Barauskas, Edoardo De Robertis, David Faraoni, Daniela C Filipescu, Dietmar Fries, Thorsten Haas, Matthias Jacob, Marcus D Lancé, Juan V L Pitarch, Susan Mallett, Jens Meier, Zsolt L Molnar, Niels Rahe-Meyer, Charles M Samama, Jakob Stensballe, Philippe J F Van der Linden, Anne J Wikkelsø, Patrick Wouters, Piet Wyffels, Kai Zacharowski
: The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding. Next, strategies should be employed to correct preoperative anaemia and to stabilise macrocirculation and microcirculation to optimise the patient's tolerance to bleeding. Finally, targeted interventions should be used to reduce intraoperative and postoperative bleeding, and so prevent subsequent morbidity and mortality...
June 2017: European Journal of Anaesthesiology
Cornelius Dyke, Solomon Aronson, Wulf Dietrich, Axel Hofmann, Keyvan Karkouti, Marcel Levi, Gavin J Murphy, Frank W Sellke, Linda Shore-Lesserson, Christian von Heymann, Marco Ranucci
OBJECTIVES: Perioperative bleeding is common among patients undergoing cardiac surgery; however, the definition of perioperative bleeding is variable and lacks standardization. We propose a universal definition for perioperative bleeding (UDPB) in adult cardiac surgery in an attempt to precisely describe and quantify bleeding and to facilitate future investigation into this difficult clinical problem. METHODS: The multidisciplinary International Initiative on Haemostasis Management in Cardiac Surgery identified a common definition of perioperative bleeding as an unmet need...
May 2014: Journal of Thoracic and Cardiovascular Surgery
Klaus Görlinger, Linda Shore-Lesserson, Daniel Dirkmann, Alexander A Hanke, Niels Rahe-Meyer, Kenichi A Tanaka
Bleeding is an important issue in cardiothoracic surgery, and about 20% of all blood products are transfused in this clinical setting worldwide. Transfusion practices, however, are highly variable among different hospitals and more than 25% of allogeneic blood transfusions have been considered inappropriate. Furthermore, both bleeding and allogeneic blood transfusion are associated with increased morbidity, mortality, and hospital costs. In the past decades, several attempts have been made to find a universal hemostatic agent to ensure hemostasis during and after cardiothoracic surgery...
August 2013: Journal of Cardiothoracic and Vascular Anesthesia
Y E Chee, S E Liu, M G Irwin
Management of acute coagulopathy and blood loss during major vascular procedures poses a significant haemostatic challenge to anaesthetists. The acute coagulopathy is multifactorial in origin with tissue injury and hypotension as the precipitating factors, followed by dilution, hypothermia, acidemia, hyperfibrinolysis and systemic inflammatory response, all acting as a self-perpetuating spiral of events. The problem is confounded by the high prevalence of antithrombotic agent use in these patients and intraoperative heparin administration...
September 2016: British Journal of Anaesthesia
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