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Management of severe perioperative bleeding Guidelines from the European Society of Anaesthesiology
被引:593
作者:
Kozek-Langenecker, Sibylle A.
[1
]
Afshari, Arash
[2
,3
,4
]
Albaladejo, Pierre
[5
]
Alvarez Santullano, Cesar Aldecoa
[6
]
De Robertis, Edoardo
[7
]
Filipescu, Daniela C.
[8
]
Fries, Dietmar
[9
]
Goerlinger, Klaus
[10
]
Haas, Thorsten
[11
]
Imberger, Georgina
[12
]
Jacob, Matthias
[13
]
Lance, Marcus
[14
]
Llau, Juan
[15
]
Mallett, Sue
[16
]
Meier, Jens
[17
]
Rahe-Meyer, Niels
[18
]
Samama, Charles Marc
[19
,20
]
Smith, Andrew
[21
]
Solomon, Cristina
[22
]
Van der Linden, Philippe
[23
]
Wikkelso, Anne Juul
[24
]
Wouters, Patrick
[25
]
Wyffels, Piet
[25
]
机构:
[1] Evangel Hosp Vienna, Dept Anaesthesia & Intens Care, A-1180 Vienna, Austria
[2] Univ Copenhagen, Rigshosp, Juliane Marie Ctr, Dept Anaesthesia,Mother & Childrens Sect, DK-1168 Copenhagen, Denmark
[3] Univ Hosp Geneva, Dept Pediat, Geneva, Switzerland
[4] Univ Hosp Geneva, Neonatal Intens Care Serv, Geneva, Switzerland
[5] Grenoble Univ Hosp, Dept Anaesthesia & Crit Care Med, Grenoble, France
[6] Univ Hosp Rio Hortega, Dept Anaesthesiol & Resuscitat, Valladolid, Spain
[7] Univ Naples Federico II, Dept Neurosci Odontostomatol & Reprod Sci, Naples, Italy
[8] Emergency Inst Cardiovasc Dis, Dept Cardiac Anaesthesia & Intens Care, Bucharest, Romania
[9] Med Univ Innsbruck, Dept Gen & Surg Intens Care Med, A-6020 Innsbruck, Austria
[10] Univ Duisburg Essen, Univ Hosp Essen, Dept Anaesthesiol & Intens Care Med, Essen, Germany
[11] Univ Childrens Hosp Zurich, Dept Anaesthesia, Zurich, Switzerland
[12] Copenhagen Univ Hosp, Rigshosp, Ctr Clin Intervent Res, Copenhagen Trial Unit, Copenhagen, Denmark
[13] Univ Hosp Munich, Dept Anaesthesiol, Munich, Germany
[14] Maastricht Univ, Med Ctr, Dept Intens Care, Dept Anaesthesia & Pain Therapy, Maastricht, Netherlands
[15] Univ Valencia, Hosp Clin Univ Valencia, Dept Anaesthesia & Crit Care Med, E-46003 Valencia, Spain
[16] Royal Free London NHS Fdn Trust, Dept Anaesthesia, London, England
[17] Univ Tubingen, Univ Hosp, Dept Anaesthesiol & Intens Care Med, Tubingen, Germany
[18] Franziskus Hosp Bielefeld, Dept Anaesthesiol & Crit Care Med, Bielefeld, Germany
[19] Hop Hotel Dieu, Dept Anaesthesia & Intens Care Med, Paris, France
[20] Cochin Univ Hosp, Paris, France
[21] Royal Lancaster Infirm, Dept Anaesthesia, Lancaster, England
[22] Salzburg Univ Hosp SALK, Dept Anaesthesiol Perioperat Med & Gen Intens Car, Salzburg, Austria
[23] CHU Brugmann HUDERF, Dept Anaesthesiol, Brussels, Belgium
[24] Univ Copenhagen, Herlev Hosp, Dept Anaesthesiol & Intens Care Med, DK-1168 Copenhagen, Denmark
[25] Ghent Univ Hosp, Dept Anaesthesiol, Ghent, Belgium
关键词:
ACTIVATED FACTOR-VII;
RECOMBINANT-FACTOR-VIIA;
PROTHROMBIN COMPLEX CONCENTRATE;
FRESH-FROZEN PLASMA;
RED-BLOOD-CELL;
VON-WILLEBRAND-DISEASE;
BYPASS GRAFT-SURGERY;
EPSILON-AMINOCAPROIC ACID;
TOTAL KNEE ARTHROPLASTY;
MOLECULAR-WEIGHT HEPARIN;
D O I:
10.1097/EJA.0b013e32835f4d5b
中图分类号:
R614 [麻醉学];
学科分类号:
100217 ;
摘要:
The aims of severe perioperative bleeding management are three-fold. First, preoperative identification by anamesis and laboratory testing of those patients for whom the perioperative bleeding risk may be increased. Second, implementation of strategies for correcting preoperative anaemia and stabilisation of the macro- and microcirculations in order to optimise the patient's tolerance to bleeding. Third, targeted procoagulant interventions to reduce the amount of bleeding, morbidity, mortality and costs. The purpose of these guidelines is to provide an overview of current knowledge on the subject with an assessment of the quality of the evidence in order to allow anaesthetists throughout Europe to integrate this knowledge into daily patient care wherever possible. The Guidelines Committee of the European Society of Anaesthesiology (ESA) formed a task force with members of scientific subcommittees and individual expert members of the ESA. Electronic databases were searched without language restrictions from the year 2000 until 2012. These searches produced 20 664 abstracts. Relevant systematic reviews with meta-analyses, randomised controlled trials, cohort studies, case-control studies and cross-sectional surveys were selected. At the suggestion of the ESA Guideline Committee, the Scottish Intercollegiate Guidelines Network (SIGN) grading system was initially used to assess the level of evidence and to grade recommendations. During the process of guideline development, the official position of the ESA changed to favour the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. This report includes general recommendations as well as specific recommendations in various fields of surgical interventions. The final draft guideline was posted on the ESA website for four weeks and the link was sent to all ESA members. Comments were collated and the guidelines amended as appropriate. When the final draft was complete, the Guidelines Committee and ESA Board ratified the guidelines.
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页码:270 / 382
页数:113
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