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Perioperative blood management.

Manjuladevi M, Vasudeva Upadhyaya K - Indian J Anaesth (2014)

Bottom Line: Perioperative anaemia and allogenic blood transfusion (ABT) are known to increase the risk of adverse clinical outcomes.The goals of PBM are adequate preoperative evaluation and optimization of haemoglobin and bleeding parameters, techniques to minimize blood loss, blood conservation technologies and use of transfusion guidelines with targeted therapy.Attention to these details can help in cost reduction and improved patient outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia and Critical Care, St. John's Medical College and Hospital, Johnnagara, Bengaluru, Karnataka, India.

ABSTRACT
Perioperative anaemia and allogenic blood transfusion (ABT) are known to increase the risk of adverse clinical outcomes. The quality, cost and availability of blood components are also major limitations with regard to ABT. Perioperative patient blood management (PBM) strategies should be aimed at minimizing and improving utilization of blood components. The goals of PBM are adequate preoperative evaluation and optimization of haemoglobin and bleeding parameters, techniques to minimize blood loss, blood conservation technologies and use of transfusion guidelines with targeted therapy. Attention to these details can help in cost reduction and improved patient outcome.

No MeSH data available.


Related in: MedlinePlus

Preoperative haemoglobin assessment and optimisation template (edited, electronic copy freely available at website http://www.nba.gov.au). Hb – Hemoglobin; CRP – C-reactive protein; GI – Gastrointestinal; MCV – Mean cell corpuscular volume; MCH – Mean cell corpuscular hemoglobin
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Figure 2: Preoperative haemoglobin assessment and optimisation template (edited, electronic copy freely available at website http://www.nba.gov.au). Hb – Hemoglobin; CRP – C-reactive protein; GI – Gastrointestinal; MCV – Mean cell corpuscular volume; MCH – Mean cell corpuscular hemoglobin

Mentions: Preoperative patient optimisation improves not only blood loss and transfusion requirements, but also morbidity and mortality in the perioperative period. Anaemia should be treated with iron supplementation [Figure 2] preoperatively.[16] Additional erythropoietin/erythropoiesis stimulating agents (ESA) is helpful in selected patients (e.g. chronic kidney disease, anaemia of chronic disease).[17] Discontinuation of anticoagulant therapy (e.g. warfarin, anti Xa drugs, antithrombin agents) should be considered before elective surgery with appropriate specialist consultation. Whenever possible antiplatelet agents (e.g. clopidogrel, ticagralor, prasugrel) except aspirin should be discontinued for a sufficient time prior to surgery. Patients with in situ vascular stents may require continuation of drugs. Selected patients may require shorter acting drugs (heparin, low-molecular-weight heparin) for transition. In emergency surgeries, reversal of anticoagulants (prothrombin complex concentrates [PCC], Vitamin K, Fresh frozen plasma [FFP]) and antifibrinolytics to minimize blood loss maybe instituted.[14]


Perioperative blood management.

Manjuladevi M, Vasudeva Upadhyaya K - Indian J Anaesth (2014)

Preoperative haemoglobin assessment and optimisation template (edited, electronic copy freely available at website http://www.nba.gov.au). Hb – Hemoglobin; CRP – C-reactive protein; GI – Gastrointestinal; MCV – Mean cell corpuscular volume; MCH – Mean cell corpuscular hemoglobin
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4260303&req=5

Figure 2: Preoperative haemoglobin assessment and optimisation template (edited, electronic copy freely available at website http://www.nba.gov.au). Hb – Hemoglobin; CRP – C-reactive protein; GI – Gastrointestinal; MCV – Mean cell corpuscular volume; MCH – Mean cell corpuscular hemoglobin
Mentions: Preoperative patient optimisation improves not only blood loss and transfusion requirements, but also morbidity and mortality in the perioperative period. Anaemia should be treated with iron supplementation [Figure 2] preoperatively.[16] Additional erythropoietin/erythropoiesis stimulating agents (ESA) is helpful in selected patients (e.g. chronic kidney disease, anaemia of chronic disease).[17] Discontinuation of anticoagulant therapy (e.g. warfarin, anti Xa drugs, antithrombin agents) should be considered before elective surgery with appropriate specialist consultation. Whenever possible antiplatelet agents (e.g. clopidogrel, ticagralor, prasugrel) except aspirin should be discontinued for a sufficient time prior to surgery. Patients with in situ vascular stents may require continuation of drugs. Selected patients may require shorter acting drugs (heparin, low-molecular-weight heparin) for transition. In emergency surgeries, reversal of anticoagulants (prothrombin complex concentrates [PCC], Vitamin K, Fresh frozen plasma [FFP]) and antifibrinolytics to minimize blood loss maybe instituted.[14]

Bottom Line: Perioperative anaemia and allogenic blood transfusion (ABT) are known to increase the risk of adverse clinical outcomes.The goals of PBM are adequate preoperative evaluation and optimization of haemoglobin and bleeding parameters, techniques to minimize blood loss, blood conservation technologies and use of transfusion guidelines with targeted therapy.Attention to these details can help in cost reduction and improved patient outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia and Critical Care, St. John's Medical College and Hospital, Johnnagara, Bengaluru, Karnataka, India.

ABSTRACT
Perioperative anaemia and allogenic blood transfusion (ABT) are known to increase the risk of adverse clinical outcomes. The quality, cost and availability of blood components are also major limitations with regard to ABT. Perioperative patient blood management (PBM) strategies should be aimed at minimizing and improving utilization of blood components. The goals of PBM are adequate preoperative evaluation and optimization of haemoglobin and bleeding parameters, techniques to minimize blood loss, blood conservation technologies and use of transfusion guidelines with targeted therapy. Attention to these details can help in cost reduction and improved patient outcome.

No MeSH data available.


Related in: MedlinePlus