Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients

被引：108

作者：

Raphael, Jacob ^{[1
]}

Mazer, C. David ^{[2
]}

Subramani, Sudhakar ^{[3
]}

Schroeder, Andrew ^{[4
]}

Abdalla, Mohamed ^{[5
]}

Ferreira, Renata ^{[6
]}

Roman, Philip E. ^{[7
]}

Patel, Nichlesh ^{[8
]}

Welsby, Ian ^{[9
]}

Greilich, Philip E. ^{[10
]}

Harvey, Reed ^{[11
]}

Ranucci, Marco ^{[12
]}

Heller, Lori B. ^{[13
]}

Boer, Christa ^{[14
]}

Wilkey, Andrew ^{[15
]}

Hill, Steven E. ^{[10
]}

Nuttall, Gregory A. ^{[16
]}

Palvadi, Raja R. ^{[17
]}

Patel, Prakash A. ^{[18
]}

Wilkey, Barbara ^{[19
]}

Gaitan, Brantley ^{[20
]}

Hill, Shanna S. ^{[21
]}

Kwak, Jenny ^{[22
]}

Klick, John ^{[23
]}

Bollen, Bruce A. ^{[24
]}

Shore-Lesserson, Linda ^{[25
]}

Abernathy, James ^{[26
]}

Schwann, Nanette ^{[27
,28
]}

Lau, W. Travis ^{[29
]}

机构：

[1] Univ Virginia Hlth Syst, Charlottesville, VA USA

[2] Univ Toronto, St Michaels Hosp, Toronto, ON, Canada

[3] Univ Iowa, Iowa City, IA USA

[4] Univ Wisconsin, Med Ctr, Madison, WI 53706 USA

[5] Cleveland Clin, Cleveland, OH 44106 USA

[6] Univ Washington, Med Ctr, Seattle, WA 98195 USA

[7] Centura St Anthony Hosp, Lakewood, CO USA

[8] Univ Calif San Francisco, San Francisco, CA 94143 USA

[9] Duke Univ Hosp, Durham, NC USA

[10] UT Southwestern Med Ctr, Dallas, TX USA

[11] Univ Calif Los Angeles, Med Ctr, Los Angeles, CA 90024 USA

[12] IRCCS Policlin San Donato, Milan, Italy

[13] Swedish Med Ctr, Seattle, WA USA

[14] Vrije Univ Amsterdam, Med Ctr, Amsterdam, Netherlands

[15] Abbott NW Hosp, Minneapolis, MN 55407 USA

[16] Mayo Clin, Rochester, MN USA

[17] Baylor Coll Med, Houston, TX 77030 USA

[18] Univ Penn, Med Ctr, Philadelphia, PA 19104 USA

[19] Univ Colorado, Denver, CO 80202 USA

[20] Mayo Clin, Phoenix, AZ USA

[21] Weill Cornell Med Ctr, New York, NY USA

[22] Loyola Univ, Med Ctr, 2160 S 1st Ave, Maywood, IL 60153 USA

[23] Case Western Univ, Med Ctr, Cleveland, OH USA

[24] Missoula Anesthesiol, Missoula, MT USA

[25] Northshore Univ Hosp, Zucker Sch Med Hofstra Northwell, Manhasset, NY USA

[26] Johns Hopkins Med Ctr, Baltimore, MD USA

[27] Univ S Florida, Morsani Coll Med, Lehigh Valley Hlth Network, Tampa, FL USA

[28] AAA Anesthesia Associates, Phymed Healthcare Grp, Allentown, PA USA

[29] Pacific Anesthesia, Honolulu, HI USA

来源：

JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA | 2019年 / 33卷 / 11期

关键词：

Transfusion; cardiac surgery; hemostasis; bleeding; cardiac anesthesia; PROTHROMBIN COMPLEX CONCENTRATE; RED-BLOOD-CELL; ARTERY-BYPASS GRAFT; ACUTE NORMOVOLEMIC HEMODILUTION; ACTIVATED FACTOR-VII; FRESH-FROZEN PLASMA; LONG-TERM SURVIVAL; RECOMBINANT HUMAN ANTITHROMBIN; MINI-CARDIOPULMONARY BYPASS; HEPARIN-RESISTANT PATIENTS;

D O I：

10.1053/j.jvca.2019.04.003

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research has revealed that adherence to these guidelines is poor, and as a result, a significant variability in patient transfusion practices among practitioners still remains. In addition, although utilization of point of care coagulation monitors and the use of novel therapeutic strategies for perioperative hemostasis, such as the use of coagulation factor concentrates, has increased significantly over the last decade, they are still not widely available in every institution. Therefore, despite continuous efforts, blood transfusion in cardiac surgery has declined only modestly over the last decade, remaining at 50% or greater in high -risk patients. Given these limitations and in response to new regulatory and legislature requirements, the Society of Cardiovascular Anesthesiologists has formed the Blood Conservation in Cardiac Surgery Working Group in order to organize, summarize, and disseminate the available best-practice knowledge in patient blood management in cardiac surgery. The current publication includes the summary statements and algorithms designed by the working group, after collection and review of the existing guidelines, consensus statements, and recommendations for patient blood management practices in cardiac surgery patients. The overall goal is creating a dynamic resource of easily accessible educational material that will help to increase and improve compliance with the existing evidence-based best practices of patient blood management by cardiac surgery care teams. (C) 2019 Published by Elsevier Inc.

引用

页码：2887 / 2899

页数：13

共 126 条

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