Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN.
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, Jacksonville, FL.
J Cardiothorac Vasc Anesth. 2019 May;33(5):1393-1406. doi: 10.1053/j.jvca.2018.08.001. Epub 2018 Aug 8.
Disorders affecting red blood cells (RBCs) are uncommon yet have many important physiologic considerations for patients undergoing cardiac surgery. RBC disorders can be categorized by those that are congenital or acquired, and further by disorders affecting the RBC membrane, hemoglobin, intracellular enzymes, or excessive RBC production. A foundational understanding of the physiologic derangement for these disorders is critical when considering perioperative implications and optimization, strategies for cardiopulmonary bypass, and the rapid recognition and treatment if complications occur. This review systematically outlines the RBC disorders of frequency and relevance with an emphasis on how the disorder affects normal physiologic processes, a review of the literature related to the disorder, and the implications and recommendations for patients undergoing cardiac surgery.
影响红细胞(RBC)的疾病并不常见,但对接受心脏手术的患者有许多重要的生理考虑因素。RBC 疾病可分为先天性或后天性,进一步可分为影响 RBC 膜、血红蛋白、细胞内酶或 RBC 过度生成的疾病。在考虑围手术期的影响和优化、体外循环的策略以及并发症发生时的快速识别和治疗时,对这些疾病的生理失调有一个基本的理解是至关重要的。本综述系统地概述了 RBC 疾病的频率和相关性,重点介绍了该疾病如何影响正常的生理过程,回顾了与该疾病相关的文献,并对接受心脏手术的患者提出了相关建议。